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Chapter 16     Entire Code


ARTICLE 1. STATE PUBLIC HEALTH SYSTEM.

ARTICLE 1A. UNIFORM CREDENTIALING FOR HEALTH CARE PRACTITIONERS.

ARTICLE 1B. SKILLED NURSING FACILITIES FOR VETERANS OF THE UNITED STATES ARMED FORCES.

ARTICLE 1C. HEALTH CARE PROVIDER TRANSPARENCY ACT.

ARTICLE 2. LOCAL BOARDS OF HEALTH.

ARTICLE 2A. ALTERNATIVE METHOD OF ORGANIZING LOCAL HEALTH AGENCIES.

ARTICLE 2B. FAMILY PLANNING AND CHILD SPACING.

ARTICLE 2C. HOME HEALTH SERVICES.

ARTICLE 2D. CERTIFICATE OF NEED.

ARTICLE 2E. BIRTHING CENTERS.

ARTICLE 2F. PARENTAL NOTIFICATION OF ABORTIONS PERFORMED ON UNEMANCIPATED MINORS.

ARTICLE 2G. SPECIAL SUPPLEMENTARY FOOD PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC).

ARTICLE 2H. PRIMARY CARE SUPPORT PROGRAM.

ARTICLE 2I. WOMEN\'S RIGHT TO KNOW ACT.

ARTICLE 2J. PREVENTIVE CARE PILOT PROGRAM.

ARTICLE 2K. PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY, \"PACE\".

ARTICLE 2M. THE PAIN-CAPABLE UNBORN CHILD PROTECTION ACT.

ARTICLE 2N. NEONATAL ABSTINENCE CENTERS.

ARTICLE 2O. UNBORN CHILD PROTECTION FROM DISMEMBERMENT ABORTION ACT.

ARTICLE 3. PREVENTION AND CONTROL OF COMMUNICABLE AND OTHER INFECTIOUS DISEASES.

ARTICLE 3A. REPOSITORY OF INFORMATION ON MEDICAL TREATMENT FOR CERTAIN HAZARDOUS MATERIALS; REQUEST FOR INFORMATION; PENALTIES; ENFORCEMENT.

ARTICLE 3B. PERTUSSIS.

ARTICLE 3C. AIDS-RELATED MEDICAL TESTING AND RECORDS CONFIDENTIALITY ACT.

ARTICLE 3D. TUBERCULOSIS TESTING, CONTROL, TREATMENT AND COMMITMENT.

ARTICLE 4. SEXUALLY TRANSMITTED DISEASES.

ARTICLE 4A. PRENATAL EXAMINATION.

ARTICLE 4B. AUTOPSIES ON BODIES OF DECEASED PERSONS.

ARTICLE 4C. EMERGENCY MEDICAL SERVICES ACT.

ARTICLE 4D. AUTOMATED EXTERNAL DEFIBRILLATORS.

ARTICLE 4E. UNIFORM MATERNAL SCREENING ACT.

ARTICLE 4F. EXPEDITED PARTNER THERAPY.

ARTICLE 5. VITAL STATISTICS.

ARTICLE 5A. CANCER CONTROL.

ARTICLE 5B. HOSPITALS AND SIMILAR INSTITUTIONS.

ARTICLE 5C. NURSING HOMES.

ARTICLE 5D. ASSISTED LIVING RESIDENCES.

ARTICLE 5E. REGISTRATION AND INSPECTION OF SERVICE PROVIDERS IN LEGALLY UNLICENSED HEALTH CARE HOMES.

ARTICLE 5F. HEALTH CARE FINANCIAL DISCLOSURE.

ARTICLE 5G. OPEN HOSPITAL PROCEEDINGS.

ARTICLE 5H. CHRONIC PAIN CLINIC LICENSING ACT.

ARTICLE 5I. HOSPICE LICENSURE ACT.

ARTICLE 5J. CLINICAL LABORATORIES QUALITY ASSURANCE ACT.

ARTICLE 5K. EARLY INTERVENTION SERVICES FOR CHILDREN WITH DEVELOPMENTAL DELAYS.

ARTICLE 5L. LONG-TERM CARE OMBUDSMAN PROGRAM.

ARTICLE 5M. OSTEOPOROSIS PREVENTION EDUCATION ACT.

ARTICLE 5N. RESIDENTIAL CARE COMMUNITIES.

ARTICLE 5O. MEDICATION ADMINISTRATION BY UNLICENSED PERSONNEL.

ARTICLE 5P. SENIOR SERVICES.

ARTICLE 5Q. THE JAMES \"TIGER\" MORTON CATASTROPHIC ILLNESS FUND.

ARTICLE 5R. THE ALZHEIMER\'S SPECIAL CARE STANDARDS ACT.

ARTICLE 5S. OLDER WEST VIRGINIANS ACT.

ARTICLE 5T. OFFICE OF DRUG CONTROL POLICY.

ARTICLE 5U. ARTHRITIS PREVENTION EDUCATION ACT.

ARTICLE 5V. EMERGENCY MEDICAL SERVICES RETIREMENT SYSTEM ACT.

ARTICLE 5W. WEST VIRGINIA OFFICIAL PRESCRIPTION PROGRAM ACT.

ARTICLE 5X. CAREGIVER ADVISE, RECORD AND ENABLE ACT.

ARTICLE 5Y. MEDICATION-ASSISTED TREATMENT PROGRAM LICENSING ACT.

ARTICLE 5Z. COALITION FOR DIABETES MANAGEMENT.

ARTICLE 6. HOTELS AND RESTAURANTS.

ARTICLE 7. PURE FOOD AND DRUGS.

ARTICLE 8. ELECTROLOGISTS.

ARTICLE 8A. NARCOTIC DRUGS.

ARTICLE 8B. DANGEROUS DRUGS ACT.

ARTICLE 9. OFFENSES GENERALLY.

ARTICLE 9A. TOBACCO USAGE RESTRICTIONS.

ARTICLE 9B. IMPLEMENTING TOBACCO MASTER SETTLEMENT AGREEMENT.

ARTICLE 9C. STATE TOBACCO GROWERS\' SETTLEMENT BOARD.

ARTICLE 9D. ENFORCEMENT OF STATUTES IMPLEMENTING TOBACCO MASTER SETTLEMENT AGREEMENT.

ARTICLE 9E. DELIVERY SALES OF TOBACCO.

ARTICLE 9F. COUNTERFEIT CIGARETTES.

ARTICLE 10. UNIFORM DETERMINATION OF DEATH ACT.

ARTICLE 11. SEXUAL STERILIZATION.

ARTICLE 12. SANITARY DISTRICTS FOR SEWAGE DISPOSAL.

ARTICLE 13. SEWAGE WORKS AND STORMWATER WORKS.

ARTICLE 13A. PUBLIC SERVICE DISTRICTS.

ARTICLE 13B. COMMUNITY IMPROVEMENT ACT.

ARTICLE 13C. DRINKING WATER TREATMENT REVOLVING FUND ACT.

ARTICLE 13D. REGIONAL WATER AND WASTEWATER AUTHORITY ACT.

ARTICLE 13E. COMMUNITY ENHANCEMENT ACT.

ARTICLE 14. BARBERS AND COSMETOLOGISTS.

ARTICLE 15. STATE HOUSING LAW.

ARTICLE 16. HOUSING COOPERATION LAW.

ARTICLE 17. NATIONAL DEFENSE HOUSING.

ARTICLE 18. SLUM CLEARANCE.

ARTICLE 19. ANATOMICAL GIFT ACT.

ARTICLE 20. AIR POLLUTION CONTROL.

ARTICLE 21. BLOOD DONATIONS.

ARTICLE 22. DETECTION AND CONTROL OF PHENYLKETONURIA, GALACTOSEMIA, HYPOTHYROIDISM, AND CERTAIN OTHER DISEASES IN NEWBORN CHILDREN.

ARTICLE 22A. TESTING OF NEWBORN INFANTS FOR HEARING IMPAIRMENTS.

ARTICLE 22B. BIRTH SCORE PROGRAM.

ARTICLE 23. TRANSFUSION OF BLOOD; TRANSPLANTING HUMAN ORGANS OR TISSUE.

ARTICLE 24. STATE HEMOPHILIA PROGRAM.

ARTICLE 25. DETECTION OF TUBERCULOSIS, HIGH BLOOD PRESSURE AND DIABETES.

ARTICLE 26. WEST VIRGINIA SOLID WASTE MANAGEMENT BOARD.

ARTICLE 27. STORAGE AND DISPOSAL OF RADIOACTIVE WASTE MATERIALS.

ARTICLE 27A. BAN ON CONSTRUCTION OF NUCLEAR POWER PLANTS.

ARTICLE 28. ASSISTANCE TO KOREAN AND VIETNAM VETERANS EXPOSED TO CERTAIN CHEMICAL DEFOLIANTS OR HERBICIDES OR OTHER CAUSATIVE AGENTS, INCLUDING AGENT ORANGE.

ARTICLE 29. HEALTH CARE RECORDS.

ARTICLE 29A. WEST VIRGINIA HOSPITAL FINANCE AUTHORITY ACT.

ARTICLE 29B. HEALTH CARE AUTHORITY.

ARTICLE 29C. INDIGENT CARE.

ARTICLE 29D. STATE HEALTH CARE.

ARTICLE 29E. LEGISLATIVE OVERSIGHT COMMISSION ON HEALTH AND HUMAN RESOURCES ACCOUNTABILITY.

ARTICLE 29F. UNINSURED AND UNDERINSURED PILOT PROGRAMS.

ARTICLE 29G. WEST VIRGINIA HEALTH INFORMATION NETWORK.

ARTICLE 29H. INTERAGENCY HEALTH COUNCIL.

ARTICLE 29I. WEST VIRGINIA HEALTH CARE AUTHORITY REVOLVING LOAN AND GRANT FUND.

ARTICLE 30. WEST VIRGINIA HEALTH CARE DECISIONS ACT.

ARTICLE 30A. MEDICAL POWER OF ATTORNEY.

ARTICLE 30B. HEALTH CARE SURROGATE ACT.

ARTICLE 30C. DO NOT RESUSCITATE ACT.

ARTICLE 31. COMMUNITY RIGHT TO KNOW.

ARTICLE 32. ASBESTOS ABATEMENT.

ARTICLE 33. BREAST AND CERVICAL CANCER PREVENTION AND CONTROL ACT.

ARTICLE 34. LICENSURE OF RADON MITIGATORS, TESTERS, CONTRACTORS AND LABORATORIES.

ARTICLE 35. LEAD ABATEMENT.

ARTICLE 36. NEEDLESTICK INJURY PREVENTION.

ARTICLE 37. BODY PIERCING STUDIO BUSINESS.

ARTICLE 38. TATTOO STUDIO BUSINESS.

ARTICLE 39. PATIENT SAFETY ACT.

ARTICLE 40. STATEWIDE BIRTH DEFECTS INFORMATION SYSTEM.

ARTICLE 41. ORAL HEALTH IMPROVEMENT ACT.

ARTICLE 42. COMPREHENSIVE BEHAVIORAL HEALTH COMMISSION.

ARTICLE 43. ENGINE COOLANT AND ANTIFREEZE.

ARTICLE 44. THE PULSE OXIMETRY NEWBORN TESTING ACT.

ARTICLE 45. TANNING FACILITIES.

ARTICLE 46. ACCESS TO OPIOID ANTAGONISTS ACT.

ARTICLE 47. ALCOHOL AND DRUG OVERDOSE PREVENTION AND CLEMENCY ACT.

ARTICLE 48. WEST VIRGINIA ABLE ACT.

ARTICLE 49. WEST VIRGINIA CLEARANCE FOR ACCESS: REGISTRY AND EMPLOYMENT SCREENING ACT.

ARTICLE 50. EPINEPHRINE AUTO-INJECTOR AVAILABILITY AND USE.

ARTICLE 51. RIGHT TO TRY ACT.

ARTICLE 52. COALITION FOR RESPONSIBLE PAIN MANAGEMENT.

ARTICLE 53. ESTABLISHING ADDITIONAL SUBSTANCE ABUSE TREATMENT FACILITIES.

ARTICLE 54. OPIOID REDUCTION ACT.

ARTICLE 54. STATE ADVISORY COALITION ON PALLIATIVE CARE.

ARTICLE 2L. PROVIDER SPONSORED NETWORKS.

§16-2L-1. Legislative purpose.

The Legislature finds that it inures to the benefit of the state and its Medicaid populations to foster the development of care systems and Medicaid options that allow for the functional integration and participation of privately practicing physicians with provider sponsored networks who have patient-centered medical home resources and who are willing to share access and use of those resources; that privately practicing physicians provide indispensable and important health care services to Medicaid enrollees in West Virginia but many do not have the resources to develop patient-centered medical homes in their respective practices; that federally qualified health centers are deeply engaged with integrating behavioral health providers and other community services in their care of Medicaid beneficiaries and that such centers lead in the development and implementation of recognized medical homes in West Virginia; and that better health outcomes can be achieved and inappropriate utilization avoided through the integration and coordination of physical health care with mental health care. Therefore, in order to develop innovative means of meeting the health care needs of the state's citizens and to address the impact on the state's budget arising from the growing cost of Medicaid, and in recognition of the important role that federally qualified health centers play in providing health care services to Medicaid beneficiaries, the Legislature authorizes the secretary to enter into contracts with provider sponsored networks.

§16-2L-2. Definitions.

As used in this article, unless the context requires otherwise:

(1) "Continuity-of-care" means the clinical practice of a medical professional who provides care to patients in which:

(A) In addition to episodic or urgent care provided from time to time as needed, preventive care and counseling is provided and a patient's overall health status is monitored even when illness is not present or not in crisis; and

(B) Without being limited to discrete episodes of care, medical records and care processes are used that track and manage health status over time and allow the medical professional to refer care to, and receive reports from, other medical professionals and other care team members responsible for a patient's care.

(2) "Federally Qualified Health Center" means an entity as defined in 42 U.S.C. §1396d(l)(2)(B).

(3) "Medicaid beneficiary" means any person participating, through either a state plan amendment or waiver demonstration, in any Medicaid program administered by the West Virginia Department of Health and Human Resources or its Bureau for Medical Services.

(4) "Medical home" means a team-based model of care in a patient-centered medical home.

(5) "Participating provider" means a licensed health care provider who has entered into a contract with a provider sponsored network to provide services to Medicaid enrollees.

(6) "Participating primary care provider" is a primary care provider who is also a participating provider.

(7) "Patient-centered medical home" means a health care setting as described in section nine, article twenty-nine-h of this chapter.

(8) "Primary care provider" means a licensed behavioral health professional or a person licensed as an allopathic or osteopathic physician primarily practicing internal medicine, family or general practice, obstetrics and gynecology, or pediatrics who provides continuity-of-care services to the majority of his or her patients.

(9) "Provider sponsored network" means an entity licensed by the West Virginia insurance commissioner in accordance with article twenty-five-g, chapter thirty-three of this code.

(10) "Secretary" means the Secretary of the West Virginia Department of Health and Human Resources.

§16-2L-3. Contracts with provider sponsored networks.

(a) The secretary is authorized to enter into contracts with any provider sponsored network licensed by the insurance commissioner in accordance with the provisions of article twenty-five-g, chapter thirty-three of this code, to arrange for the provision of health care, services and supplies for Medicaid beneficiaries. Such contract:

(1) Shall be subject to the same criteria and standards applied to other managed care organizations; and

(2) May provide that the provider sponsored network will share with the department up to 25% of any net profits realized during the period of the contract.

(b) The service, administrative and performance criteria to be met by provider sponsored networks shall be the same as required of other managed care organizations providing services to Medicaid beneficiaries in the state.

(c) A licensed provider sponsored network shall be deemed an HMO for the purposes of federal regulations governing the Medicaid program to the extent permitted by such regulations.

§16-2L-4. Options for Medicaid beneficiaries; assignment of enrollees.

(a) Notwithstanding the prior availability or utilization of other options, every licensed provider sponsored network available in a county shall be offered by the secretary as an enrollment option to that county's Medicaid beneficiaries. A provider sponsored network is deemed to be "available in a county" if the secretary has entered into a contract with it to provide services to Medicaid beneficiaries in that county.

(b) The secretary shall require that each eligible Medicaid beneficiary be given the option to choose any available managed care plan, including a provider sponsored network, to arrange for and provide his or her medical services under the Medicaid program, and nothing in this article shall be construed to remove or diminish the right of Medicaid beneficiaries to choose among such available options.

(c) The secretary shall seek approval from the Centers for Medicare and Medicaid Services to permit the assignment to an available provider sponsored network of any Medicaid beneficiary who does not exercise the option to choose a managed care plan or provider sponsored network offered to him or her. The secretary shall promulgate emergency rules and shall propose for legislative approval legislative rules as may be necessary to implement such assignment process.

(d) A Medicaid beneficiary assigned to a provider sponsored network or another managed care organization may change enrollment to any other available provider sponsored network or managed care organization as such options may be available, and nothing in this article requires that a Medicaid beneficiary who is a patient of a participating provider must remain an enrollee in the provider sponsored network with which such participating provider has a contract.

§16-2L-5. Anti-trust exemption.

Because agreement and coordination among health care providers, who may be potential competitors with each other, is required to establish and operate provider sponsored networks, an exemption from anti-trust laws for these activities will further the purposes of this article. Therefore, the West Virginia Anti-Trust Act, article eighteen, chapter forty-seven of this code, is inapplicable to the development of provider sponsored networks, activities necessary to operate provider sponsored networks or any arrangements or agreements between or among provider sponsored networks and participating providers that are performed or entered into consistent with and pursuant to the provisions of this article and the provisions of article twenty-five-g, chapter thirty-three of this code. It is the intent of the Legislature that the federal anti-trust statutes be interpreted in this manner as well.

§16-2L-6. Rulemaking authority.

The secretary may promulgate emergency rules and shall propose for legislative approval legislative rules, in accordance with the provisions of article three, chapter twenty-nine-a of this code, as are necessary to provide for implementation and enforcement of the provisions of this article.

§16-2L-7. Reports to the Legislature.

The secretary shall include in his or her annual report to the Legislature the status of the provider sponsored network programs operating during the previous fiscal year.

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