§9-5-25. Medicaid Program Compact
(a) The Secretary of the Department of Health and Human Resources shall contact West Virginia’s surrounding states to discuss the creation of a compact. This compact would enable each states’ health care providers to be eligible to be paid for services provided to the other states’ Medicaid participants. (b) The Secretary shall provide a report […]
§9-5-26. Supplemental Medicare and Medicaid Reimbursement
(a) A ground emergency medical transportation services provider, owned, operated by, or providing services under contract to, the state, or a city, a county, or city and county, that provides services to Medicare and Medicaid beneficiaries is eligible for supplemental reimbursement. (b) An eligible provider’s supplemental reimbursement shall be calculated and paid as follows: (1) […]
§9-5-27. Transitioning Foster Care Into Managed Care
(a) “Eligible services” means acute care, including medical, pharmacy, dental, and behavioral health services. (b) The secretary shall transition to a capitated Medicaid program for a child classified as a foster child and a child placed in foster care under Title IV-E of the Social Security Act who is living in the state by January […]
§9-5-28. Requirement for Telehealth Rates
The Medicaid plan, which issues, renews, amends, or adjusts a plan, policy, contract, or agreement on or after July 1, 2021, shall provide reimbursement for a telehealth service at a rate negotiated between the provider and the insurance company for virtual telehealth encounters. The Medicaid plan, which issues, renews, amends, or adjusts a plan, policy, […]
§9-5-29. Payments to Substance Use Disorder Residential Treatment Facilities Based Upon Performance-Based Outcomes
(a) For purposes of this section: (1) “Department” means the Department of Health and Human Resources.
§9-5-30. Certified Community Behavioral Health Clinics
(a) The Bureau for Medical Services shall develop, seek approval of, and implement a Medicaid state plan amendment as necessary and appropriate to effectuate a system of certified community behavioral health clinics (CCBHCs). (b) The Bureau for Medical Services, in partnership with the Department of Health and Human Resources Bureau for Behavioral Health, shall establish […]
§9-5-19. Summary Review for Certain Behavioral Health Facilities and Services
(a) A certificate of need as provided in article two-d, chapter sixteen of this code is not required by an entity proposing additional behavioral health care services, but only to the extent necessary to gain federal approval of the Medicaid MR/DD waiver program, if a summary review is performed in accordance with the provisions of […]
§9-5-20. Medicaid Program; Chronic Kidney Disease; Evaluation and Classification
(a) Any enrollee in Medicaid who is eligible for services and who has a diagnosis of diabetes or hypertension or, who has a family history of kidney disease, shall receive coverage for an evaluation for chronic kidney disease through routine clinical laboratory assessments of kidney function. (b) Any enrollee in Medicaid who is eligible for […]
§9-5-21. Annual Report to Joint Committee on Government and Finance Regarding Treatment for Autism Spectrum Disorders Provided by the Bureau for Medical Services
(a) On or before January 1 each year, the agency shall file an annual report with the joint committee on government and finance describing the number of enrolled individuals with autism spectrum disorder, including the fiscal and administrative impact of treatment of autism spectrum disorders, and any recommendations the agency may have as to changes […]
§9-5-22. Medicaid Managed Care Reporting
(a) Beginning January 1, 2016, and annually thereafter, the Bureau for Medical Services shall submit an annual report by May of that year to the Joint Committee on Government and Finance and the Legislative Oversight Commission on Health and Human Resources Accountability that includes, but is not limited to, the following information for all managed […]