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WHEELING — West Virginia Senate Majority Whip Ryan Weld said a possible legislative solution to ongoing Public Employees’ Insurance compensation issues could be resolved as early as Wednesday — the first day of the West Virginia Legislature’s upcoming regular session.
On Thursday, VVU Medicine Wheeling Hospital announced it would no longer accept PEIA patients, citing inadequate reimbursement to that hospital and others across the state.
But Weld, R-Brooke, noted last year that the Senate passed Senate Bill 574, which calls for an increase in PEIA reimbursement rates for hospitals in the state.
He asked Senate President Craig Blair, R-Berkeley, if the bill could be brought back on the first day of the session, and Blair agreed.
“The Senate had a bill (SB 574) that we passed unanimously last year,” Weld continued. “We did it out of recognition that nobody was doing anything to improve reimbursement rates, and we wanted to avoid the kind of announcement that came (Thursday).”
The legislation, introduced by Sen. Mike Maroney, R-Marshall, has not been considered in the House of Representatives.
He called for raising the state hospital reimbursement rate from 59% to 110% of the federal Medicare reimbursement rate.
“Given what happened (Thursday), I asked Senate President Blair if we could do this bill on the first day of the legislature because of the enormity of the problem and knowing it needs to be addressed,” Weld said. “There could be other solutions, but this is the one we are all familiar with.”
“PEIA has always had a huge structural imbalance in its program and is constantly in need of help.” We have to find a permanent solution.”
Union leaders representing Ohio county school employees are telling members that they still have their Public Employees Insurance Agency right now — at least until July 1, and that they should contact their state legislators now to make sure the issue is a priority at the beginning of the upcoming legislative session.
Ohio County School Service Association President Jerry Ames said he called VVU Medicine’s central business office in Morgantown twice Thursday and gave them his name and title as OCSSPA president.
Both times, different employees read him verbatim the email they had received telling them “the situation needs to be resolved soon”.
He made a follow-up call on Friday morning and was told the same thing.
“I’ve had three people tell me that (that the problem will be fixed) and I take their word for it,” Ames added.
Messages left by the Sunday News-Register with the same office Friday were not immediately returned.
Ames hopes that an announcement will be made soon indicating that PEIA coverage at Wheeling Hospital will continue after July 1.
“I don’t want our people to be scared not knowing if they will be insured.” “I feel sorry for them,” Ames said.
For now, all employees with PEIA health insurance have health insurance, he continued.
“It’s as good as gold right now,” Ames added. “The date listed is July 1.”
Wheeling Hospital’s move Thursday comes less than a week before West Virginia lawmakers meet in regular session in Charleston.
Ames called Wheeling Hospital’s withdrawal of PEIA coverage a “scare tactic” as they seek a higher reimbursement rate for the procedures. He is also not sure what will happen in this session of Parliament regarding PEIA funding.
Lawmakers are considering how best to spend the $1.3 billion budget surplus, and will likely discuss using some of the money to strengthen the PEIA system.
“Why don’t they allow more reimbursement?” Ames asked. “Then they have a surplus.” Maybe it needs to be redistributed in a different way.
“They need to stop worrying about the (proposed) 10% tax cut or the inventory tax cut.” It’s all a big political game.”
Ohio County Education Association President Jenny Craig is urging those with PEIA insurance — even if they’ve chosen the health plan option as coverage — to contact their legislators this weekend before the start of the regular session Wednesday to stress the importance of strengthening PEIA.
She spoke to legislators herself, as well as other state officials. One of the questions everyone had was whether the VVU Medicine-Wheeling Hospital decision would affect public employees who choose the health plan option offered to them instead of the PEIA option.
VVU Health System President and CEO Albert Wright confirmed Friday that the health plan option will be included in Wheeling Hospital’s PEIA regulation. Wright said reimbursements from PEIA and the health plan option are about the same.
“We have a lot of concerns,” Craig said. “We at the (West Virginia Education Association) hope that there will be a lot of good work during the legislative session on funding PEIA and winding it down so that both members and hospital systems can afford and accept PEIA coverage.” This is the goal that VVEA has been fighting for since (the teachers’ strike) in 2018.
“The pressure will be on the Legislature to intervene and ensure that PEIA insurance is solvent and affordable enough not only for members, but also for hospitals to accept coverage.”
While Wheeling Hospital is the only hospital to announce it will not accept PEIA insurance after July, Craig noted that there is concern that others in the VVU Medicine system and other hospitals in the state may soon follow suit.
“The reimbursement rate is low and work will have to be done this session to correct the differences,” she continued. “That is why it is important that this be a priority at the beginning of the session.”
Wheeling Hospital’s announcement not only affects teachers and school staff, but also state troopers, corrections officers and city and government workers. And the vast majority of state employees in West Virginia get coverage through PEIA, according to Craig.
“Funding PEIA will have to be a renewed top priority at the start of the session or there will be a crisis,” she said. “We need to have a long-term financing solution.”
Craig admits she’s not sure what that will look like.
She noted that after the 2018 teacher strike, the Legislature pledged to fully fund and have a reliable funding stream for PEIA. A working group was formed to deal with this issue, “but it has not met for two years,” she continued.
School employees often forgo health screenings, surgeries and doctor appointments until the summer when they have time off, and so often do their families, Craig explained.
Another issue is that many local doctors are affiliated with Wheeling Hospital, and it’s already difficult to find a primary care doctor, she added.
“The first of July is not a long time – only a few months, and only if everyone can act quickly,” Craig continued. “Our members need to get in touch with representatives in the next week, so the Legislature is making that a priority when the session starts.” Now is the time to do it before the session starts.”
Delegate Charlie Reynolds, R-Marshall, released a statement Friday saying he sent a letter to Gov. Jim Justice regarding the PEIA issue.
He states in the letter that the PEIA issues “need to be resolved immediately.”
“My constituents, and residents of the entire Northern Panhandle, are seriously harmed by this decision because an extremely high percentage of my constituents rely on PEIA and VVU Medicine for their health care needs,” Reynolds wrote. “West Virginia taxpayers are getting the short end of the stick as two state-funded entities are at odds with each other.”
“Gov. Justice, at the end of the day, no matter how complex the issues, our common constituents are losing meaningful access to health care,” he continued. “Quite simply, this is the worst government and my constituents deserve better.” These issues should be resolved immediately. Accordingly, I request that your office immediately coordinate and participate in a meeting involving all stakeholders and myself to address and resolve these very important issues. I look forward to working with everyone as we resolve these issues as quickly as possible.”
