We Could Not Determine Whether West Virginia's Severance and Business Privilege Tax on Behavioral Health Services Is a Permissible Health-Care-Related Tax 

We could not determine whether West Virginia's Severance and Business Privilege Tax (Severance Tax) is a permissible health-care-related tax. The Severance Tax does not place at least 85 percent of the tax burden on behavioral health services. We could not determine if the Severance Tax treats behavioral health services differently than the other items it taxes because the tax rates are not consistent and the proceeds from the tax on behavioral health services are placed in a fund different from the proceeds from the other items taxed. Citing privacy restrictions in its tax laws, West Virginia would not provide all the documents we needed to complete our analysis. We did not subpoena those records. Without this information, we could not identify the taxpayers or validate the services being taxed. As a result, we could not determine if the Severance Tax is a health-care-related tax and, if it is, whether it is a permissible health-care-related tax.