Latest news with #PEIA
Yahoo
13-06-2025
- Health
- Yahoo
Insurance dispute costs Bridgeport man potentially life-saving treatment
BRIDGEPORT, (WBOY) — For the past two years, a Bridgeport, West Virginia man suffering from cancer has been searching for an operation that could improve his health, but after denials and disputes with his insurance provider, his family says that he may have missed his chance. A report from NBC News on Thursday night spoke about Eric Tennant, a Bridgeport resident who works at the West Virginia Office of Miners' Health Safety and Training and suffers from a rare cancer found in his bile ducts. He was diagnosed at stage 4 in 2023 and wasn't expected to survive a year, dropping below 100 pounds at one point. In fall 2024, following nearly two years of chemotherapy treatment, Tennant's wife, Rebecca, learned of a way to potentially aid his condition through a 'relatively new' procedure known as histotripsy, NBC News reported. The procedure would use ultrasound waves to target tumors in Tennant's liver and could potentially extend his life. His insurance declined to cover the $50,000 treatment. Tennant is insured under West Virginia's Public Employee Insurance Agency (PEIA), and despite receiving a recommendation for the procedure from his oncologist, PEIA cited the treatment as 'not medically necessary,' NBC News reported. West Virginia woman who traveled 6 hours for life-saving abortion calls for issue to be placed on voter ballot After learning of PEIA's denial, NBC News reported that the Tennant family attempted to appeal the agency four separate times, all to no avail. Along the way, they were faced with other roadblocks such as UMR, a subsidiary of United Healthcare that manages PEIA plans through a contract with West Virginia, as well as MES Peer Review Services, a Massachusetts-based company that upheld PEIA's decision in March, saying that histotripsy is 'unproven in this case and is not medically necessary.' NBC News interviewed the Tennants in April and noted that after it and KFF Health News reached out to PEIA with questions for its story, the agency changed its tune. PEIA officials told NBC News that the agency had 'consulted with medical experts to further evaluate the case' and that Tennant was now, seemingly out of nowhere, approved for a histotripsy. PEIA Director Brent Wolfingbarger told the outlet that the decision to approve Tennant 'reflects a rare and exceptional situation' and doesn't represent a change in PEIA's overall coverage policies. Despite the sudden approval, Rebecca Tennant told NBC News that it may be too late. She said that since Eric was evaluated in February, his health has declined significantly, resulting in him having to spend five days in the hospital in late May and early June due to lung and heart complications. As a result of his health declining, Rebecca told NBC News that Eric is no longer considered a viable candidate for a histotripsy. She said she's hopeful that he will be viable once again after his health improves, but blames PEIA for 'wasting months' of their time. 'Time is precious,' she said. 'They know he has stage 4 cancer, and it's almost like they don't care if he lives or dies.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
05-06-2025
- Business
- Yahoo
WV Legislature may be called for PEIA special session in July
The Public Employees Insurance Agency is proposing increasing premiums by 14% for state employees and by 16% for local government employees during the 2026 fiscal year. (Lori Kersey | West Virginia Watch) While West Virginia employees prepare for their health insurance to take up more of their paychecks this summer, a special session may be coming in July — the same month those increases take effect — to deal with ongoing cost and sustainability challenges at the Public Employees Insurance Agency. At the finance board's regular meeting Thursday, Chairman Eric Householder said the agency has been working with Gov. Patrick Morrisey's office as he prepares to call the special legislative session. 'I know currently … we are working providing data to the governor,' Householder said. 'There's been no decision on what to do, just providing data, having roundtable discussions. That's all we're doing right now.' Householder said Morrisey tentatively intends to call a special session for PEIA in mid July. Beginning in July, PEIA premiums are increasing by 14% for state employees and by 16% for local government employees. Out-of-pocket and copay costs will also go up. The agency will also raise premiums by 12% for retirees. PEIA leaders have said that the rising cost of health care — particularly inflation on prescription GLP-1 drugs that treat obesity and diabetes — are a major driver of the rate increases. Union leaders and state employees have repeatedly called on the Legislature to come up with a solution to PEIA's rising costs, but the issue largely went unaddressed during the 2025 regular session. Morrisey said in April that he plans to call a special session for PEIA, but he has not said how exactly the issue of increasing costs will be addressed.. 'That was kicked down the road for many, many years,' the governor said in April. 'I don't intend to kick it down the road. We have to bring everyone together, all the stakeholders: listen, learn and then you'll be seeing some activity.' In a news release Thursday, leadership from the West Virginia Democratic Party blamed Morrisey for 'falling to act' and letting 'devastating' PEIA increases go into effect. 'Pay-Cut Patrick failed to take action to stabilize PEIA premiums,' Democratic Party Chair Mike Pushkin said in the statement. 'So now, state employees, including law enforcement officers, school teachers, school service personnel, CPS workers, and retirees will soon be paying a price for his inaction. Morrisey had a choice — he could have fought to protect working West Virginians. Instead, he did what he always does: protect his political donors and let working families bear the burden.' In an email Thursday, Morrisey spokesman Drew Galang said the governor has emphasized that the state 'must address the inherited challenges facing PEIA and its long term sustainability.' He said Morrisey had 'already indicated' that a special session to do so would occur in 'mid to late July.' Galang did not respond to an email asking to clarify when, publicly, the July timeframe had been set by Morrisey and no such references to it have been made clear in previous PEIA meetings or announcements prior to Thursday. A spokeswoman for the House of Delegates and one for the state Senate said the governor has not formally told lawmakers the special session will be in July. Dale Lee, president of the West Virginia Education Association, told Householder the discussions about PEIA solutions should include public employees and their representatives. 'The employees can't be the ones providing all of this,' Lee said of the cost increases. 'We have to have the Legislature. There has to be not only the Legislature but also the providers. That's why I continue to ask that we all go back to the table and that we come up with a plan that people can agree on.' Lee, who has repeatedly criticized state leaders for failing to act on the recommendations of a task force called by former Gov. Jim Justice after statewide teacher strikes in 2018 and 2019, said it's important that the Legislature act upon a plan for PEIA this time. '[It] never even got on a committee agenda,' he said of the recommendations. 'That's just disingenuous.'
Yahoo
31-05-2025
- Business
- Yahoo
Planned PEIA rate increases elicit concern from lawmakers and policyholders
BECKLEY, WV (WVNS) – Hundreds of thousands of West Virginians with PEIA coverage are set to see rate increases in the coming months. With increases of up to 16% in premiums expected to impact certain West Virginia residents as early as July according to PEIA, members of the general public along with state lawmakers have voiced concerns regarding the coverage provider. While many say a change is in order, no one can seem to agree on how to appropriately address financial concerns associated with the program. 'We keep doing things that they tell us is going to fix the problem and then it ends up not fixing the problem,' Delegate Eric Brooks told 59News. 'We'll see what the options are when we get back down there. I think the governor is really pushing for a Special Session to deal with this before January when we have our next legislative session.' A bill introduced during the most recent session of the West Virginia Legislature – House Bill 2623 – would abolish PEIA altogether, though some detractors have characterized the legislation as reckless. The bill was under consideration by the House Committee on Health and Human Resources at the time the most recent legislative session was brought to a close. Governor Patrick Morrisey told 59News he has been working with the legislature to address issues with PEIA, citing an overall need for fiscal responsibility on the state level. 'We have a lot of tough challenges ahead. I've mentioned that we have PEIA that'll be coming up in the upcoming months,' said Morrisey. 'We've been diligently working on that and are starting to have conversations with the legislature. We want to get that right because we have to make sure that we help West Virginia reach her potential.' Several delegates have said they expect to be called in for a session to address PEIA specifically, and the governor says he hopes to address the issue in the coming months, though an official call for a Special Session of the legislature has yet to be made at this time. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
24-04-2025
- Health
- Yahoo
Morrisey says he'll call special session for PEIA
Gov. Patrick Morrisey held a press conference to discuss his first 100 days in office in Wheeling, on Wednesday, April 23, 2025. (West Virginia Office of the Gov. Patrick Morrisey | Courtesy photo) West Virginia Gov. Patrick Morrisey said he plans to call a special legislative session to address the rising costs of state employee health insurance coverage. Speaking during a press conference Wednesday, Morrisey said he'd bring lawmakers back to Charleston to tackle issues including the Public Employees Insurance Agency. 'That's important. I thought that would be best for a special session, to be honest,' Morrisey said. 'Because you can bring everyone. You can focus it. It's a complicated issue. We want to get it right. 'That was kicked down the road for many, many years,' the governor said. 'I don't intend to kick it down the road. We have to bring everyone together, all the stakeholders: listen, learn and then you'll be seeing some activity.' Morrisey's news conference, which he held in Wheeling, marked his first 100 days in office. More than 200,000 state employees and thousands of local government workers rely on PEIA for their health insurance. Beginning in July, PEIA premiums are increasing by 14% for state employees and by 16% for local government employees. Out-of-pocket and copay costs are also increasing. The agency will also raise premiums by 12% for retirees. PEIA leaders have said that the rising cost of health care, particularly inflation for prescription GLP-1 drugs that treat obesity and diabetes, are a major driver of the rate increases. Following the regular session, union leaders reiterated calls that the program be stabilized. 'It's a good benefit. We need to keep it at a good benefit,' West Virginia ALF-CIO president Josh Sword told West Virginia Watch. 'We also know that public sector workers generally make less than those in the private sector, and one of the reasons that it's attractive, therefore, to work in the public sector is because you've generally had access to PEIA, which is a good health care benefit for the employee and their family. 'You take that away, or you destroy a pretty good benefit program so that it is not what it used to be, then you've lost that incentive to attract and retain qualified individuals in the public sector,' he said. This year's state budget included $64 million more in spending for PEIA than last year's budget. The appropriation is in line with the funding Morrisey level requested for the agency, according to a spokeswoman for the Senate. Senate president Randy Smith and House of Delegates Speaker Roger Hanshaw were not available for comment on Thursday. Senate communications director Jacque Bland said Smith would not be surprised by the governor's remarks indicating a special session, which Morrisey has talked about before. Ann Ali, communications director and deputy chief of staff for the House of Delegates, said Hanshaw's reaction would likely depend on what specific proposals the governor has. Morrisey did not outline any specific ideas for PEIA during his press conference Wednesday. 'Extraordinary sessions for various reasons have become commonplace, but Speaker Hanshaw's response when asked for potential reaction or feedback to any general proposal from the previous governor was usually that the House would have to see the bill(s) for how that proposal would be structured,' Ali said. House Minority Leader Sean Hornbuckle, D-Cabell, said lawmakers need to go beyond allocating money to PEIA and consider structural changes. He said finding solutions should involve bringing various stakeholders together. 'We need to look at serious, what I would call long-term structural enhancements to the program to make sure that the promise that we made state workers many, many moons ago isn't eroded, and we follow through on that,' Hornbuckle said. 'That's very important to me, from a state perspective.' He added that he would have preferred that time during the regular session were dedicated to PEIA and not to vaccine exemption bills and legislation ending diversity, equity and inclusion programs. 'The priorities of the supermajority Republicans are not in line with everyday West Virginians,' he said. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
18-04-2025
- Business
- Yahoo
These items were vetoed from West Virginia's 2026 budget
CHARLESTON, (WBOY) — West Virginia Gov. Patrick Morrisey signed the state's budget for Fiscal Year 2026 Thursday night, and some things that were approved by congress didn't make the cut. In a press release Thursday night, Morrisey called the budget 'fiscally conservative' and applauded the West Virginia Legislature for passing a budget that 'closely resembles my original proposal and begins to address long term issues while funding West Virginia priorities.' Morrisey signs bill allowing teachers to remove students from class Here are the items that Morrisey chose to reduce or veto from the budget passed by the legislature. The listed dollar amount is how much money will be saved from the changes. Keep in mind that the following cuts are not to the amount previously given, but to the amounts approved by the West Virginia Legislature for Fiscal Year 2026. Funding for Willowbend Agricultural Innovation Center ($100,000) Funding for Mountwood Park ($300,000) Funding for Math Counts within MATH Program ($50,000) Funding for Green Acres Regional Center, Inc ($300,000) Funding for West Virginia College of Law ($250,000) Funding for LPN to BSN ($250,000) Funding for Directed Transfer – Surplus, 'to address likely fiscal challenges related to Medicaid, PEIA and potential changes to the federal tax code' ($85,000,000) Funding for Current Expense – Surplus, 'to address likely fiscal challenges related to Medicaid, PEIA and potential changes to the federal tax code' ($250,000) 2% reduction for Local Economic Assistance ($100,000) 10% reduction for Tourism – Industry Development ($300,000) 33% reduction for Martinsburg Berkeley Public Library ($500,000) 3% reduction for Safe Schools ($200,000) Within Safe Schools, 6% reduction in funding for school mapping ($200,000) 70% reduction for Computer Science Education ($1,400,000) 23% reduction for Mountain State Digital Literacy Program ($300,000) 60% reduction for Ronald McDonald House of Morgantown ($3,000,000) 9% reduction for In-Home Family Education ($100,000) 5% reduction for West Virginia State Police Trooper Class ($161,172) 73% reduction for Court Appointed Special Advocates (CASA) ($800,000) 40% reduction for Federal Funds/Grant Match ($500,000) 1.6% reduction for Veterans Nursing Home ($187,650) 13.5% reduction for Tuition Contract Program ($208,000) 3.5% reduction for Maintenance related to State Road Funds ($25,000,000) 20% reduction for Direct Transfer – Surplus, 'to address likely fiscal challenges related to Medicaid, PEIA and potential changes to the federal tax code' ($25,000,000) Morrisey did clarify in his press release that 'the budget fully funds Medicaid, senior services, and the HOPE scholarship.' He also said that 'In the case of a surplus, up to $100 million will be allocated to funding road maintenance and improvement projects across the state.' You can read Morrisey's full communication regarding the budget to Secretary of State Kris Warner here, which includes reasons for his vetoes. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
