The West Virginia Legislature, through W.Va. Code §§33-15-4u, 33-16-3ff, 33-24-7u, 33-25-8r, and W.Va. Rule 114-64-7.3 and 8. charges the West Virginia Offices of the Insurance Commissioner (OIC) to annually issue a mandatory data call and provide a detailed report to the Joint Committee on Government and Finance, on the status of behavioral, mental health and substance used disorder parity. That detailed report must address adverse benefit determinations, quantitative treatment limitations (QTLs), financial requirements (FRs), and comparative analyses of all nonquantitative treatment limitations (NQTLs).
Under Section 203 of the Federal Consolidated Appropriations Act and 42 U.S.C. § 300gg-26(a)(8)(A), state-regulated health plans and health insurance issuers are now required to conduct annual compliance reviews of all NQTLs, document their comparative analyses, and submit these analyses including supporting documentation, to the state upon request.
Required reporting forms consist of both the MHPAEA NQTL and Claims Worksheet and the MHPAEA FR and QTL Worksheet.