H. B. 2066

(By Delegate Farris)
[Introduced February 13, 1997; referred to the
Committee on Health and Human Resources then Government Organization.]




A Bill to amend and reenact section three-b, article sixteen, chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, relating to requiring the state licensing of home health care agencies; requiring the department of health and human resources to provide for such licensing; and providing that licensing requirements be reasonable and in accordance with the specific coverages set forth by this section relative to services, treatments or other assistance rendered by any home health care agency.
Be it enacted by the Legislature of West Virginia:
That section three-b, article sixteen, chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be amended and reenacted to read as follows:
Article 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-3b. Home health care coverage.
(a) Any insurer who, on or after the first day of January, one thousand nine hundred eighty-one, delivers or issues for delivery in this state group basic hospital expense or major medical expense coverage under this article shall make available to the policyholder home health care coverage consistent with the provisions of this section. For purposes of this section, "home health care" means health services provided by a home health agency certified in the state in which the home health services are delivered or under Title XVIII of the Social Security Act: Provided, That any home health agency rendering services in this state shall be licensed in accordance with the reasonable requirements of the department of health and human resources. The department of health and human resources is hereby directed to propose rules prescribing reasonable requirements that upon legislative approval, shall be complied with before any home health agency may be issued a license. These requirements shall issue in accordance with the requirements of this section regarding inclusions of coverage and shall set forth basic minimum standards regarding the provision of any service, treatment or other assistance specified as being covered hereunder.
(b) Home health care coverage offered shall include:
(1) Services provided by a registered nurse or a licensed practical nurse;
(2) Health services provided by physical, occupational, respiratory and speech therapists;
(3) Health services provided by a home health aide to the extent that such services would be covered if provided to the insured on an inpatient basis;
(4) Medical supplies, drugs, medicines and laboratory services to the extent that they would be covered if provided to the insured on an inpatient basis; and
(5) Services provided by a licensed midwife or a licensed nurse midwife as these occupations are defined in section one, article fifteen, chapter thirty of the code.
(c) Home health care coverage may be limited to:
(1) Services provided on the written order of a licensed physician, provided such order is renewed at least every sixty days;
(2) Services provided, directly or through contractual agreements, by a home health agency certified in the state in which the home health services are rendered or under Title XVIII of the Social Security Act; and
(3) Services as set forth in subsection (b) of this section without which the insured would have to be hospitalized.
(d) Coverage under this section shall be provided for at least one hundred home visits per insured per policy year, with each home visit by a member of a home health care team to be considered as one home health care visit including up to four hours of home health care services.
(e) No such policy need provide such coverage to persons eligible for medicare.


NOTE: The purpose of this bill is to require the licensing of home health care agencies by this state.

Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.