A BILL to amend article two, chapter nine of the code of West Virginia, one thousand nine hundred thirty-one, as amended, by adding thereto a new section, designated section ten, relating to mandatory managed care medicaid contracting.

That article two, chapter nine of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be amended by adding thereto a new section, designated section ten, to read as follows:

§9-2-10. Mandatory managed care medicaid contracting.
(a) Effective with the next contract renewal or the first day of July, two thousand, whichever occurs first, the secretary of the department of health and human resources shall require that all agreements with health insurers or health maintenance organizations for health care services for managed care in counties in which participation is mandatory, contain a requirement for use of traditional medicaid providers. All terms and conditions of the health insurers or managed care organizations contract(s) with such providers shall be substantially similar to those offered to other providers serving the county and shall not discriminate against a provider. The provisions of this subsection shall expire on the thirtieth day of June, two thousand three.
(b) The secretary shall define (1) which services are to be provided by traditional medicaid providers, and (2) the criteria to determine which providers qualify as traditional medicaid providers: Provided, That traditional medicaid providers shall include health care providers which have had medicaid provider agreements in place for two years or more.
(c) If the secretary determines, based upon actual findings presented, that the quality of care from providers may be compromised, or that the cost of the services may exceed the costs within the traditional fee for service program, the secretary may determine for the specific service that it is not in the best interest of the medicaid beneficiary or program to use the traditional provider and may waive the requirements of this section.