On March 8, 2023, the West Virginia Senate passed Senate Bill 476, which would exempt managed care contracts from certain purchasing requirements, allowing the Department of Health and Human Resources Bureau of Medical Services to return to an application process for managed care organizations seeking to do business in West Virginia. Currently, the Bureau uses an RFP process to select up to three managed care organizations. Under the new bill, this cap would be removed and the Bureau would be permitted to approve additional organizations. The bill was sent to the Governor on March 10.