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WEST VIRGINIA LEGISLATURE
2026 REGULAR SESSION
ENROLLED
Committee Substitute for
House Bill 4196
BY DELEGATES DRENNAN, WORRELL, HITE, AMOS,
CROUSE, PINSON, BURKHAMMER, JEFFRIES, HECKERT,
AND HALL
[Passed February 20, 2026; in effect 90 days from
passage (May 21, 2026)]
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1 AN ACT to amend and reenact §16B-13-5 of the Code of West Virginia, 1931, as amended,
2 relating to establishing reversible contraception to patients; and establishing parameters
3 of how to offer long-acting reversible contraception.
Be it enacted by the Legislature of West Virginia
ARTICLE 13. MEDICATION-ASSISTED TREATMENT PROGRAM LICENSING ACT.
§16B-13-5. Operational requirements.
1 (a) The medication-assisted treatment program shall be licensed and registered in this
2 state with the director, the Secretary of State, the State Tax Department, and all other applicable
3 business or licensing entities.
4 (b) The program sponsor need not be a licensed physician but shall employ a licensed
5 physician for the position of medical director when required by the rules promulgated pursuant to
6 this article.
7 (c) Each medication-assisted treatment program shall designate a medical director. If the
8 medication-assisted treatment program is accredited by a Substance Abuse and Mental Health
9 Services Administration-approved accrediting body that meets nationally accepted standards for
10 providing medication-assisted treatment, including the Commission on Accreditation of
11 Rehabilitation Facilities or the Joint Commission on Accreditation of Healthcare Organizations,
12 then the program may designate a medical director to oversee all facilities associated with the
13 accredited medication-assisted treatment program. The medical director shall be responsible for
14 the operation of the medication-assisted treatment program, as further specified in the rules
15 promulgated pursuant to this article. He or she may delegate the day-to-day operation of a
16 medication-assisted treatment program as provided in rules promulgated pursuant to this article.
17 Within 10 days after termination of a medical director, the medication-assisted treatment program
18 shall notify the director of the identity of another medical director for that program. Failure to have
19 a medical director practicing at the program may be the basis for a suspension or revocation of
20 the program license. The medical director shall:
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21 (1) Have a full, active, and unencumbered license to practice allopathic medicine or
22 surgery from the West Virginia Board of Medicine or to practice osteopathic medicine or surgery
23 from the West Virginia Board of Osteopathic Medicine in this state and be in good standing and
24 not under any probationary restrictions;
25 (2) Meet both of the following training requirements:
26 (A) If the physician prescribes a partial opioid agonist, he or she shall complete the
27 requirements for the Drug Addiction Treatment Act of 2000; and
28 (B) Complete other programs and continuing education requirements as further described
29 in the rules promulgated pursuant to this article;
30 (3) Practice at the licensed or registered medication-assisted treatment program a
31 sufficient number of hours, based upon the type of medication-assisted treatment license or
32 registration issued pursuant to this article, to ensure regulatory compliance, and carry out those
33 duties specifically assigned to the medical director as further described in the rules promulgated
34 pursuant to this article;
35 (4) Be responsible for monitoring and ensuring compliance with all requirements related
36 to the licensing and operation of the medication-assisted treatment program;
37 (5) Supervise, control, and direct the activities of each individual working or operating at
38 the medication-assisted treatment program, including any employee, volunteer, or individual
39 under contract, who provides medication-assisted treatment at the program or is associated with
40 the provision of that treatment. The supervision, control, and direction shall be provided in
41 accordance with rules promulgated by the Inspector General; and
42 (6) Complete other requirements prescribed by the Inspector General by rule.
43 (d) Each medication-assisted treatment program shall designate counseling staff, either
44 employees or those used on a referral-basis by the program, which meet the requirements of this
45 article and the rules promulgated pursuant to this article. The individual members of the
46 counseling staff shall have one or more of the following qualifications:
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47 (1) Be a licensed psychiatrist;
48 (2) Be certified as an alcohol and drug counselor;
49 (3) Be certified as an advanced alcohol and drug counselor;
50 (4) Be a counselor, psychologist, marriage and family therapist, or social worker with a
51 master’s level education with a specialty or specific training in treatment for substance use
52 disorders, as further described in the rules promulgated pursuant to this article;
53 (5) Be a counselor with a bachelor's degree in social work or another relevant human
54 services field under the direct supervision of an advanced alcohol and drug counselor: Provided,
55 That the individual practicing with a bachelor's degree under supervision applies for certification
56 as an alcohol and drug counselor within three years of the date of employment as a counselor;
57 (6) Be a counselor with a graduate degree actively working toward licensure or certification
58 in the individual’s chosen field under supervision of a licensed or certified professional in that field
59 and/or advanced alcohol and drug counselor;
60 (7) Be a psych-mental health nurse practitioner or a psych-mental health clinical nurse
61 specialist; or
62 (8) Be a psychiatry CAQ-certified physician assistant.
63 (e) The medication-assisted treatment program shall be eligible for, and not prohibited
64 from, enrollment with West Virginia Medicaid and other private insurance. Prior to directly billing
65 a patient for any medication-assisted treatment, a medication-assisted treatment program must
66 receive either a rejection of prior authorization, rejection of a submitted claim, or a written denial
67 from a patient’s insurer or West Virginia Medicaid denying coverage for that treatment: Provided,
68 That the director, in consultation with the Inspector General, may grant a variance from this
69 requirement pursuant to §16B-13-6 of this code. The program shall also document whether a
70 patient has no insurance. At the option of the medication-assisted treatment program, treatment
71 may commence prior to billing.
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72 (f) The medication-assisted treatment program shall apply for and receive approval as
73 required from the United States Drug Enforcement Administration, Center for Substance Abuse
74 Treatment, or an organization designated by the Substance Abuse and Mental Health and Mental
75 Health Administration.
76 (g) All persons employed by the medication-assisted treatment program shall comply with
77 the requirements for the operation of a medication-assisted treatment program established within
78 this article or by any rule adopted pursuant to this article.
79 (h) All employees of an opioid treatment program shall furnish fingerprints for a state and
80 federal criminal records check by the Criminal Identification Bureau of the West Virginia State
81 Police and the Federal Bureau of Investigation. The fingerprints shall be accompanied by a signed
82 authorization for the release of information and retention of the fingerprints by the Criminal
83 Identification Bureau and the Federal Bureau of Investigation. The opioid treatment program shall
84 be subject to the provisions of §16B-15-1 et seq. of this code and subsequent rules promulgated
85 thereunder.
86 (i) The medication-assisted treatment program may not be owned by, nor may it employ
87 or associate with, any physician or prescriber whose:
88 (1) Drug Enforcement Administration number is not currently full, active, and
89 unencumbered;
90 (2) Application for a license to prescribe, dispense, or administer a controlled substance
91 has been denied by and is not full, active, and unencumbered in any jurisdiction; or
92 (3) License is anything other than a full, active, and unencumbered license to practice
93 allopathic medicine or surgery by the West Virginia Board of Medicine or osteopathic medicine or
94 surgery by the West Virginia Board of Osteopathic Medicine in this state, and who is in good
95 standing and not under any probationary restrictions.
96 (j) A person may not dispense any medication-assisted treatment medication, including a
97 controlled substance as defined by §60A-1-101 of this code, on the premises of a licensed
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98 medication-assisted treatment program, unless he or she is a physician or pharmacist licensed in
99 this state and employed by the medication-assisted treatment program unless the medication-
100 assisted treatment program is a federally certified narcotic treatment program. Prior to dispensing
101 or prescribing medication-assisted treatment medications, the treating physician must access the
102 Controlled Substances Monitoring Program Database to ensure the patient is not seeking
103 medication-assisted treatment medications that are controlled substances from multiple sources
104 and to assess potential adverse drug interactions, or both. Prior to dispensing or prescribing
105 medication-assisted treatment medications, the treating physician shall also ensure that the
106 medication-assisted treatment medication utilized is related to an appropriate diagnosis of a
107 substance use disorder and approved for that usage. The physician shall also review the
108 Controlled Substances Monitoring Program Database no less than quarterly and at each patient’s
109 physical examination. The results obtained from the Controlled Substances Monitoring Program
110 Database shall be maintained with the patient’s medical records.
111 (k) A medication-assisted treatment program responsible for medication administration
112 shall comply with:
113 (1) The West Virginia Board of Pharmacy regulations;
114 (2) The West Virginia Board of Examiners for Registered Professional Nurses regulations;
115 (3) All applicable federal laws and regulations relating to controlled substances; and
116 (4) Any requirements as specified in the rules promulgated pursuant to this article.
117 (l) Each medication-assisted treatment program location shall be licensed separately,
118 regardless of whether the program is operated under the same business name or management
119 as another program.
120 (m) The medication-assisted treatment program shall develop and implement patient
121 protocols, treatment plans, or treatment strategies and profiles, which shall include, but not be
122 limited by, the following guidelines:
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123 (1) When a physician diagnoses an individual as having a substance use disorder, the
124 physician may treat the substance use disorder by managing it with medication in doses not
125 exceeding those approved by the United States Food and Drug Administration as indicated for
126 the treatment of substance use disorders and not greater than those amounts described in the
127 rules promulgated pursuant to this article. The treating physician and treating counselor’s
128 diagnoses and treatment decisions shall be made according to accepted and prevailing standards
129 for medical care;
130 (2) The medication-assisted treatment program shall maintain a record of all of the
131 following:
132 (A) Medical history and physical examination of the individual;
133 (B) The diagnosis of substance use disorder of the individual;
134 (C) The plan of treatment proposed, the patient’s response to the treatment, and any
135 modification to the plan of treatment;
136 (D) The dates on which any medications were prescribed, dispensed, or administered; the
137 name and address of the individual for whom the medications were prescribed, dispensed, or
138 administered; and the amounts and dosage forms for any medications prescribed, dispensed, or
139 administered;
140 (E) A copy of the report made by the physician or counselor to whom referral for evaluation
141 was made, if applicable; and
142 (F) A copy of the coordination of care agreement, which is to be signed by the patient,
143 treating physician, and treating counselor. If a change of treating physician or treating counselor
144 takes place, a new agreement must be signed. The coordination of care agreement must be
145 updated or reviewed at least annually. If the coordination of care agreement is reviewed, but not
146 updated, this review must be documented in the patient’s record. The coordination of care
147 agreement will be provided in a form prescribed and made available by the director;
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148 (3) Medication-assisted treatment programs shall report information, data, statistics, and
149 other information as directed in this code and the rules promulgated pursuant to this article to
150 required agencies and other authorities;
151 (4) A prescriber authorized to prescribe a medication-assisted treatment medication who
152 practices at a medication-assisted treatment program is responsible for maintaining the control
153 and security of his or her prescription blanks and any other method used for prescribing a
154 medication-assisted treatment medication. The prescriber shall comply with all state and federal
155 requirements for tamper-resistant prescription paper. In addition to any other requirements
156 imposed by statute or rule, the prescriber shall notify the director and appropriate law-enforcement
157 agencies, in writing, within 24 hours following any theft or loss of a prescription blank or breach
158 of any other method of prescribing a medication-assisted treatment medication;
159 (5) The medication-assisted treatment program shall have a drug testing program to
160 ensure a patient is in compliance with the treatment strategy; and
161 (6) The medication-assisted treatment program shall offer long-acting reversible
162 contraception to patients recovering from addiction; such offerings shall be provided in
163 accordance with the following provisions:
164 (A) Contraceptive Counseling Requirement:
165 (i) The medication-assisted treatment program shall provide shared decision-making
166 contraceptive counseling;
167 (ii) Counseling shall be non-coercive and tailored to the patient’s lifestyle, health needs,
168 and personal preferences, ensuring informed choice in contraceptive options;
169 (iii) Counseling services shall be available to both male and female patients; and
170 (iv) Medical eligibility screening for potential contraindications;
171 (B) Medical Assessment & Referral Process:
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172 (i) The medication-assisted treatment program may not place or insert a long-acting
173 reversible contraception unless they have a licensed healthcare provider on staff who is trained;
174 and
175 (ii) If the medication-assisted treatment program lacks a qualified provider or necessary
176 medical equipment, it shall establish a referral system to direct patients to a licensed healthcare
177 provider or clinic capable of full contraceptive service delivery.
178 (n) Medication-assisted treatment programs shall only prescribe, dispense, or administer
179 liquid methadone to patients pursuant to the restrictions and requirements of the rules
180 promulgated pursuant to this article.
181 (o) The medication-assisted treatment program shall immediately notify the director, or his
182 or her designee, in writing of any changes to its operations that affect the medication-assisted
183 treatment program’s continued compliance with the certification and licensure requirements.
184 (p) If a physician treats a patient with more than 16 milligrams per day of buprenorphine
185 then clear medical notes shall be placed in the patient's medical file indicating the clinical reason
186 or reasons for the higher level of dosage.
187 (q) If a physician is not the patient’s obstetrical or gynecological provider, the physician
188 shall consult with the patient’s obstetrical or gynecological provider to the extent possible to
189 determine whether the prescription is appropriate for the patient.
190 (r) A practitioner providing medication-assisted treatment may perform certain aspects of
191 telehealth if permitted under his or her scope of practice.
192 (s) The physician shall follow the recommended manufacturer’s tapering schedule for the
193 medication-assisted treatment medication. If the schedule is not followed, the physician shall
194 document it in the patient’s medical record and the clinical reason why the schedule was not
195 followed. The director may investigate a medication-assisted treatment program if a high
196 percentage of its patients are not following the recommended tapering schedule.
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The Clerk of the House of Delegates and the Clerk of the Senate hereby
certify that the foregoing bill is correctly enrolled.
...............................................................
Clerk of the House of Delegates
...............................................................
Clerk of the Senate
Originated in the House of Delegates.
In effect 90 days from passage.
...............................................................
Speaker of the House of Delegates
...............................................................
President of the Senate
__________
The within is ................................................ this the...........................................
Day of ..........................................................................................................., 2026.
.............................................................
Governor
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