State Law

West Virginia Code-Chapter 33-Article 2. Insurance Commissioner

08/28/2023 West Virginia Section 33-2-24

Authority of Insurance Commissioner to Enforce No Surprises Act; Administrative Penalties; Injunctive Relief; Regulatory Assistance of Other Agencies; Rulemaking; Effective Date

OON-Payment Issues

(a) The Insurance Commissioner shall enforce the applicable provisions of the No Surprises Act (H.R. 133, Public Law 116-260) against health insurers, medical providers, and health care facilities.

(b) Whenever the Insurance Commissioner believes, from evidence satisfactory to him or her, that any insurer, medical provider, or health care facility is violating the applicable provisions of the No Surprises Act, the Commissioner may assess a fine, not to exceed $10,000 per violation, after notice and hearing pursuant to §33-2-13 of this code.  In addition to the administrative penalty available in this subsection, the Insurance Commissioner may cause a complaint to be filed in the appropriate court of this state seeking to enjoin and restrain the insurer, medical provider, or health care facility from continuing the violation or engaging therein or doing any act in furtherance thereof.

(c) The Insurance Commissioner may, at his or her discretion, seek assistance from any other state government agency regarding regulatory enforcement of this section against medical providers or health care facilities.  The Insurance Commissioner may also call upon the Attorney General for legal assistance and representation as provided by law.

(d)  The Insurance Commissioner may propose rules for legislative approval in accordance with §29A-3-1 et seq. of this code to effectuate the provisions of this section.

(e) The provisions of this section shall become effective January 1, 2022.