A West Virginia Senate committee on March 5, 2025 reported a committee substitute for Senate Bill 726 to the full Senate with the recommendation that it pass as amended.

Committee counsel told members the substitute would require opioid treatment programs and office-based medication-assisted treatment (OBMAT) programs to offer certain medical and wraparound services on-site, define an integrated care model, and phase in expanded services on internal effective dates (including an expansion by April 1, 2026). The substitute requires programs to provide an informed-consent document on admission and quarterly thereafter explaining risks and benefits of treatment options, and to perform quarterly assessments of a client's status to support physical, mental and psychosocial wellbeing. Counsel said the Office of the Inspector General would have rulemaking authority and the bill includes a 90-day general effective date with internal trigger dates for specific provisions; the substitute also carries a second reference to the Committee on Finance.

The committee heard testimony and questioning from witnesses and senators about how to preserve access in rural areas while preventing low-quality or fraud-prone telehealth models. Dr. Matthew Christiansen, a board-certified family and addiction medicine physician affiliated with Valley Health Systems, told the committee that many high-quality programs already provide wraparound services and that the bill would "raise that foundational floor, that level of support that people with addiction would get, across the state in many of those programs." He and other witnesses described transportation, mobile units and grants as tools to extend in-person services to rural areas.

Dr. Lloyd, director of the Office of Drug Control Policy, described both benefits and risks of telehealth and said telehealth can be an important bridge for patients but cautioned that low-quality telehealth models had been abused during the pandemic. "The opposite of addiction is not recovery. It's community and relationship," Dr. Lloyd said, arguing for in-person relationships while noting telehealth's role as a bridge.

During floor discussion the committee adopted an amendment that allows telehealth for medication-assisted-treatment visits only up to a limit of 33 percent of visits per patient, requires that telehealth sessions be provided by qualified professionals (licensed professional counselors or licensed clinical social workers as described in the amendment), and requires documentation of the reason for using telehealth instead of in-person care. The amendment also directs the Office of the Inspector General to promulgate rules and allows for emergency rulemaking; committee members asked for a report back to the Legislature within six months on implementation and any needed adjustments. Committee counsel confirmed that Medicaid non-emergency medical transport is a reimbursable service for eligible Medicaid enrollees, which members discussed as one way to extend in-person care to remote areas.

The vice chair moved that the committee substitute for SB 726 be reported to the full Senate with the recommendation that it do pass as amended and be referred first to the Committee on Finance under the bill's double-reference; the chair declared the voice vote adopted.

The substitute, as explained in committee and amended on telehealth limits, moves to the full Senate for further consideration.