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West Virginia Code
Chapter 33
25A
Health Maintenance Organization Act.
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33-25A-1
Short title and purpose.
33-25A-2
Definitions.
33-25A-3
Application for certificate of authority.
33-25A-3a
Conditions precedent to issuance or maintenance of a certificate of authority; renewal of certificate of authority; effect of bankruptcy proceedings.
33-25A-4
Issuance of certificate of authority.
33-25A-5
Powers of health maintenance organizations.
33-25A-6
Governing body.
33-25A-7
Fiduciary responsibilities of officers; fidelity bond; approval of contracts by commissioner.
33-25A-7a
Provider contracts.
33-25A-7b
Loss ratio.
33-25A-8
Evidence of coverage; charges for health care services; review of enrollee records; cancellation of contract by enrollee.
33-25A-8a
Third party reimbursement for mammography, pap smear or human papilloma virus testing.
33-25A-8b
Third party reimbursement for rehabilitation services.
33-25A-8c
Third party payment for child immunization services.
33-25A-8d
Coverage of emergency services.
33-25A-8e
Third party reimbursement for colorectal cancer examination and laboratory testing.
33-25A-8f
Required coverage for reconstruction surgery following mastectomies.
33-25A-8g
Required use of mail-order pharmacy prohibited.
33-25A-8h
Third-party reimbursement for kidney disease screening.
33-25A-8i
Third-party reimbursement for dental anesthesia services.
33-25A-8j
Coverage for diagnosis and treatment of autism spectrum disorders.
33-25A-8k
Maternity coverage.
33-25A-8l
Deductibles, copayments and coinsurance for anti-cancer medications.
33-25A-8m
Eye drop prescription refills.
33-25A-8n
Deductibles, copayments and coinsurance for abuse-deterrent opioid analgesic drugs.
33-25A-8o
Step therapy.
33-25A-8p
Lyme disease to be covered by all health insurance policies.
33-25A-8q
Coverage for amino acid-based formulas.
33-25A-8r
Substance use disorder.
33-25A-8s
Prior authorization.
33-25A-8t
Fairness in Cost-Sharing Calculation.
33-25A-8u
Mental health parity.
33-25A-8v
Incorporation of the Health Benefit Plan Access and Adequacy Act.
33-25A-8w
Incorporation of the coverage for 12-month refill for contraceptive drugs.
33-25A-8x
Copayments for certain services.
33-25A-8y
Coverage of emergency medical services to triage and transport to alternative destination or treat in place.
33-25A-9
Annual report.
33-25A-10
Information to enrollees.
33-25A-11
Open enrollment period.
33-25A-12
Grievance procedure.
33-25A-13
Investments.
33-25A-14
Prohibited advertising practices.
33-25A-14a
Other prohibited practices.
33-25A-15
Agent licensing and appointment required; regulation of marketing.
33-25A-16
Powers of insurers and hospital and medical service corporations.
33-25A-17
Examinations.
33-25A-17a
Quality assurance.
33-25A-18
Suspension or revocation of certificate of authority.
33-25A-19
Rehabilitation, liquidation or conservation of health maintenance organization.
33-25A-20
Regulations.
33-25A-21
Administrative procedures.
33-25A-22
Fees.
33-25A-23
Penalties and enforcement.
33-25A-23a
Civil penalty imposed by commissioner.
33-25A-24
Scope of provisions; applicability of other laws.
33-25A-24a
W. Va. Code § 33-25A-24a
Repealed
33-25A-24b
W. Va. Code § 33-25A-24b
Repealed
33-25A-25
Filings and reports as public documents.
33-25A-26
Confidentiality of medical information.
33-25A-27
Authority to contract with health maintenance organizations under Medicaid.
33-25A-28
Required health maintenance organization option.
33-25A-29
W. Va. Code § 33-25A-29
Repealed
33-25A-30
W. Va. Code § 33-25A-30
Repealed
33-25A-31
Policies discriminating among health care providers.
33-25A-32
Authority of commissioner to promulgate rules and regulations regarding affiliate and subsidiary operating results.
33-25A-33
Guaranty fund.
33-25A-34
Ambulance services.
33-25A-35
Rural health maintenance organizations.
33-25A-36
Assignment of certain benefits in dental care insurance coverage.