Quick answer: West Virginia has no specified state law recognized under the No Surprises Act. This means the federal IDR process governs virtually all surprise billing disputes in West Virginia, for both fully-insured and self-funded plans.
Because West Virginia has not enacted its own qualifying balance billing statute, the federal No Surprises Act framework applies by default. Providers and facilities use the federal IDR portal after the mandatory 30-business-day open negotiation period, and disputes are decided using the federal "baseball-style" arbitration process, where the certified IDR entity selects one of the two parties' offers based primarily on the Qualifying Payment Amount (QPA).
Federal No Surprises Act protections took effect January 1, 2022, and apply uniformly across all plan types in the state since there is no separate state IDR process.
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