FISCAL NOTE
Date Requested: January 16, 2026
Time Requested: 09:31 AM |
| Agency: |
Insurance Commission |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1025 |
Introduced |
HB4197 |
|
|---|
| CBD Subject: |
Health; Insurance |
|---|
|
FUND(S):
7152
Sources of Revenue:
Special Fund
Legislation creates:
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
House Bill 4197, if enacted, would provide coverage under the West Virginia Children's Health Insurance Program for physician prescribed treatment deemed medically necessary for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS).
HB4197 would have no fiscal impact on the WV Offices of the Insurance Commissioner.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2026
Increase/Decrease
(use"-") |
2027
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
0 |
0 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
0 |
| Repairs and Alterations |
0 |
0 |
0 |
| Assets |
0 |
0 |
0 |
| Other |
0 |
0 |
0 |
| 2. Estimated Total Revenues |
0 |
0 |
0 |
Explanation of above estimates (including long-range effect):
Please explain increases and decreases in personal services, current expenses, repairs and alterations, assets, other costs and revenues, including assumptions and data sources and delineation between start-up and ongoing costs. Please also include a long-range schedule of costs and revenues if fiscal impact is expected to vary in future years.
Memorandum
House Bill 4197, if enacted, would provide coverage under the West Virginia Children's Health Insurance Program for physician prescribed treatment deemed medically necessary for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS).
HB4197 would not impact insurance premium rates in the commercial health market considering the bill's provisions apply only to the West Virginia Children's Health Insurance Program, which is not administered or regulated by the WV Offices of the Insurance Commissioner.
Children's Health Insurance Agency should be consulted regarding the fiscal impact to those programs.
It should be noted that HB4197 does not contain language limiting the insurance benefits provided under the proposed bill to the essential health benefits (EHB) specified under section 130(b) of the Patient Protection and Affordable Care Act (PPACA). PPACA 1311 (d)(3) provides that a state must defray the cost by direct payment to enrollees or to the Plan of any state mandated benefit in excess of the EHB. To the extent that the health insurance benefits required by HB4197 do not fall within the EHB, a potential cost to the State exists.
Person submitting Fiscal Note: Rhonda C Hartwell
Email Address: rhonda.c.hartwell@wv.gov