West Virginia Code
1 - STATE PUBLIC HEALTH SYSTEM
1A - UNIFORM CREDENTIALING FOR HEAL
1B - SKILLED NURSING FACILITIES FOR
1C - HEALTH CARE PROVIDER TRANSPARE
2 - LOCAL BOARDS OF HEALTH
2A - ALTERNATIVE METHOD OF ORGANIZI
2B - FAMILY PLANNING AND CHILD SPAC
2C - HOME HEALTH SERVICES
2D - CERTIFICATE OF NEED
2E - BIRTHING CENTERS
2F - PARENTAL NOTIFICATION OF ABORT
2G - SPECIAL SUPPLEMENTARY FOOD PRO
2H - PRIMARY CARE SUPPORT PROGRAM
2I - WOMEN'S RIGHT TO KNOW ACT
2J - PREVENTIVE CARE PILOT PROGRAM
2K - PROGRAMS OF ALL-INCLUSIVE CARE
2L - PROVIDER SPONSORED NETWORKS
2M - THE PAIN-CAPABLE UNBORN CHILD
2N - NEONATAL ABSTINENCE CENTERS
2O - UNBORN CHILD PROTECTION FROM D
3 - PREVENTION AND CONTROL OF COMMU
3A - REPOSITORY OF INFORMATION ON M
3B - PERTUSSIS
3C - AIDS-RELATED MEDICAL TESTING A
3D - TUBERCULOSIS TESTING, CONTROL,
4 - SEXUALLY TRANSMITTED DISEASES
4A - PRENATAL EXAMINATION
4B - AUTOPSIES ON BODIES OF DECEASE
4C - EMERGENCY MEDICAL SERVICES ACT
4D - AUTOMATED EXTERNAL DEFIBRILLAT
4E - UNIFORM MATERNAL SCREENING ACT
4F - EXPEDITED PARTNER THERAPY
5 - VITAL STATISTICS
5A - CANCER CONTROL
5B - HOSPITALS AND SIMILAR INSTITUT
5C - NURSING HOMES
5D - ASSISTED LIVING RESIDENCES
5E - REGISTRATION AND INSPECTION OF
5F - HEALTH CARE FINANCIAL DISCLOSU
5G - OPEN HOSPITAL PROCEEDINGS
5H - CHRONIC PAIN CLINIC LICENSING
5I - HOSPICE LICENSURE ACT
5J - CLINICAL LABORATORIES QUALITY
5K - EARLY INTERVENTION SERVICES FO
5L - LONG-TERM CARE OMBUDSMAN PROGR
5M - OSTEOPOROSIS PREVENTION EDUCAT
5N - RESIDENTIAL CARE COMMUNITIES
5O - MEDICATION ADMINISTRATION BY U
5P - SENIOR SERVICES
5Q - THE JAMES "TIGER" MO
5R - THE ALZHEIMER'S SPECIAL CARE S
5S - OLDER WEST VIRGINIANS ACT
5T - OFFICE OF DRUG CONTROL POLICY
5U - ARTHRITIS PREVENTION EDUCATION
5V - EMERGENCY MEDICAL SERVICES RET
5W - WEST VIRGINIA OFFICIAL PRESCRI
5X - CAREGIVER ADVISE, RECORD AND E
5Y - MEDICATION-ASSISTED TREATMENT
5Z - COALITION FOR DIABETES MANAGEM
6 - HOTELS AND RESTAURANTS
7 - PURE FOOD AND DRUGS
8 - ELECTROLOGISTS
8A - NARCOTIC DRUGS
8B - DANGEROUS DRUGS ACT
9 - OFFENSES GENERALLY
9A - TOBACCO USAGE RESTRICTIONS
9B - IMPLEMENTING TOBACCO MASTER SE
9C - STATE TOBACCO GROWERS' SETTLEM
9D - ENFORCEMENT OF STATUTES IMPLEM
9E - DELIVERY SALES OF TOBACCO
9F - COUNTERFEIT CIGARETTES
10 - UNIFORM DETERMINATION OF DEAT
11 - SEXUAL STERILIZATION
12 - SANITARY DISTRICTS FOR SEWAGE
13 - SEWAGE WORKS AND STORMWATER W
13A - PUBLIC SERVICE DISTRICTS
13B - COMMUNITY IMPROVEMENT ACT
13C - DRINKING WATER TREATMENT REV
13D - REGIONAL WATER AND WASTEWATE
13E - COMMUNITY ENHANCEMENT ACT
14 - BARBERS AND COSMETOLOGISTS
15 - STATE HOUSING LAW
16 - HOUSING COOPERATION LAW
17 - NATIONAL DEFENSE HOUSING
18 - SLUM CLEARANCE
19 - ANATOMICAL GIFT ACT
20 - AIR POLLUTION CONTROL
21 - BLOOD DONATIONS
22 - DETECTION AND CONTROL OF PHEN
22A - TESTING OF NEWBORN INFANTS F
22B - BIRTH SCORE PROGRAM
23 - TRANSFUSION OF BLOOD; TRANSPL
24 - STATE HEMOPHILIA PROGRAM
25 - DETECTION OF TUBERCULOSIS, HI
26 - WEST VIRGINIA SOLID WASTE MAN
27 - STORAGE AND DISPOSAL OF RADIO
27A - BAN ON CONSTRUCTION OF NUCLE
28 - ASSISTANCE TO KOREAN AND VIET
29 - HEALTH CARE RECORDS
29A - WEST VIRGINIA HOSPITAL FINAN
29B - HEALTH CARE AUTHORITY
29C - INDIGENT CARE
29D - STATE HEALTH CARE
29E - LEGISLATIVE OVERSIGHT COMMIS
29F - UNINSURED AND UNDERINSURED P
29G - WEST VIRGINIA HEALTH INFORMA
29H - INTERAGENCY HEALTH COUNCIL
29I - WEST VIRGINIA HEALTH CARE AU
30 - WEST VIRGINIA HEALTH CARE DEC
30A - MEDICAL POWER OF ATTORNEY
30B - HEALTH CARE SURROGATE ACT
30C - DO NOT RESUSCITATE ACT
31 - COMMUNITY RIGHT TO KNOW
32 - ASBESTOS ABATEMENT
33 - BREAST AND CERVICAL CANCER PR
16 - 33 - 1
16 - 33 - 2
16 - 33 - 3
16 - 33 - 4
16 - 33 - 5
16 - 33 - 6
16 - 33 - 7
16 - 33 - 8
16 - 33 - 9
16 - 33 - 10
16 - 33 - 11
16 - 33 - 12
34 - LICENSURE OF RADON MITIGATORS
35 - LEAD ABATEMENT
36 - NEEDLESTICK INJURY PREVENTION
37 - BODY PIERCING STUDIO BUSINESS
38 - TATTOO STUDIO BUSINESS
39 - PATIENT SAFETY ACT
40 - STATEWIDE BIRTH DEFECTS INFOR
41 - ORAL HEALTH IMPROVEMENT ACT
42 - COMPREHENSIVE BEHAVIORAL HEAL
43 - ENGINE COOLANT AND ANTIFREEZE
44 - THE PULSE OXIMETRY NEWBORN TE
45 - TANNING FACILITIES
46 - ACCESS TO OPIOID ANTAGONISTS
47 - ALCOHOL AND DRUG OVERDOSE PRE
48 - WEST VIRGINIA ABLE ACT
49 - WEST VIRGINIA CLEARANCE FOR A
50 - EPINEPHRINE AUTO-INJECTOR AVA
51 - RIGHT TO TRY ACT
52 - COALITION FOR RESPONSIBLE PAI
53 - ESTABLISHING ADDITIONAL SUBST
CHAPTER 16. PUBLIC HEALTH.
ARTICLE 33. BREAST AND CERVICAL CANCER PREVENTION AND CONTROL ACT.
This article may be cited as the "Breast and Cervical Cancer Prevention and Control Act".
As used in this article:
(a) "Advisory committee" means the medical advisory committee to the breast and cervical cancer detection and education program coalition established pursuant to the provisions of section five of this article.
(b) "Approved organization" means an organization approved by the director to provide medical services under section four of this article.
(c) "Bureau" means the state bureau of public health established pursuant to the provisions of article one of this chapter.
(d) "Department" means the Department of Health and Human Resources.
(e) "Director" means the director of the division of health.
(f) "Unserved or underserved populations" means persons having inadequate access and financial resources to obtain breast and cervical cancer screening and detection services, including persons who lack health insurance or whose health insurance coverage.
(g) "Fund" means the breast and cervical cancer diagnostic and treatment fund.
(h) "Qualified applicant" means a person who meets the financial and medical eligibility guidelines of this article.
(i) "Provider" means a physician, hospital or medical provider currently licensed, operating or practicing in this state.
(a) There is hereby created within the department the breast and cervical cancer detection and education program. This program is established to promote screening and detection of breast and cervical cancer among unserved or underserved populations, to educate the public regarding breast and cervical cancer and the benefits of early detection, and to provide counseling and referral services.
(b) The program shall include:
(1) Establishment of a public education and outreach campaign to publicize breast and cervical cancer detection and education services, including the extent of coverage for such services by health insurance, the medical assistance program and other public and private programs;
(2) Provision of grants to approved organizations under section four of this article;
(3) Compilation of data concerning the breast and cervical cancer detection and education program and dissemination of the data to the public; and
(4) Development of professional education programs including the benefits of early detection of breast and cervical cancer and the recommended frequency of screening examinations for prevention and control.
(a) The director shall make grants, within the amounts appropriated, to approved organizations for the provision of services relating to the screening and detection of breast and cervical cancer as part of this program. Such services shall include, but not be limited to:
(1) Promotion and provision of early detection of breast and cervical cancer, clinical examinations, including pap testing and mammography and breast self-examination;
(2) Provision of counseling and information on treatment alternatives and referral for appropriate medical treatment;
(3) Dissemination of information to unserved and underserved populations, to the general public and to health care professionals concerning breast and cervical cancer, the benefits of early detection and treatment and the availability of breast and cervical cancer screening services;
(4) Identification of local breast and cervical cancer screening services within the approved organization's region; and
(5) Provision of information, counseling and referral services to individuals diagnosed with breast or cervical cancer.
(b) (1) The director shall give notice and provide opportunity for organizations to submit applications to provide breast and cervical cancer detection and education programs. In order to be considered for a grant to provide breast and cervical cancer detection and education programs, applicants must show evidence of the following:
(A) Ability to provide and to ensure consistent and quality breast and cervical cancer detection services;
(B) Expertise in breast and cervical cancer detection and treatment;
(C) Capacity to collaborate and coordinate services with physicians, hospitals and other appropriate local institutions or agencies;
(D) Ability to provide breast and cervical cancer detection and education services to unserved or underserved populations; and
(E) Ability to implement a breast and cervical cancer detection and education program in accordance with national organization standards of high quality, as described in subsection (c) of this section.
(2) Applications shall be made on forms provided by the director for approval of grants to provide breast and cervical cancer detection and education programs by organizations, including, but not limited to:
(A) Local boards of health organized under articles two and two-a of this chapter;
(B) Licensed health care facilities, including the public and private sector;
(C) Any combination of the above; and
(D) Organizations with program expertise in cancer related issues.
(c) In evaluating applications the director shall consult the most recent medical practice and procedures in breast and cervical cancer detection and education standards for breast and cervical cancer detection and education programs of organizations with national recognition for expertise in breast and cervical cancer detection and treatment with the objective to ensure the following:
(1) Integration linkage and consultation with approved organizations, health care facilities and providers;
(2) Maximization of third-party reimbursement; and
(3) Provision of services to unserved or underserved populations.
(a) There is hereby established the breast and cervical cancer detection and education program coalition. The members of the coalition shall be appointed by the director and shall be representative of consumers including persons with breast or cervical cancer, local health departments, health care providers and recognized experts in the provision of health services to women, cancer research or environmental health.
(b) The breast and cervical cancer coalition shall be responsible for advising the director with respect to the implementation of this article and shall make recommendations as to the selection of approved organizations and the standards to be established by the director pursuant to subsection (c), section four of this article. The director shall consult with the coalition on standards for approved organizations, selecting approved organizations, making grants to such organizations and implementing the breast and cervical cancer detection and education program.
(c) The director shall perform an evaluation of the state's system for early detection and treatment of breast and cervical cancer and shall submit to the Legislature and the Governor a report detailing his findings and recommendations concerning the state's response to the high incidence of breast and cervical cancer. Such report shall be submitted no later than December 1,1993, and shall reflect the evaluation of the at-risk population screened for breast and cervical cancer detection for the previous twelve months.
(d) The breast and cervical cancer coalition shall meet at least three times a year to receive information and provide interaction, consultation and advice.
(e) The members of the coalition shall receive no compensation for their services, but shall be allowed their actual and necessary expenses incurred in performance of their duties.
The director shall submit an annual report to the Governor and the Legislature concerning the operation of the breast and cervical cancer detection and education program including available data and assessment. Such report shall also include any recommendations for additional action to respond to the high incidence of breast and cervical cancer in this state.
(a) There is hereby established the breast and cervical cancer diagnostic and treatment fund which shall provide financial assistance for the medical care of indigent patients for diagnostic and treatment services for breast and cervical cancer.
(b) The fund may be comprised of moneys appropriated to the fund by the Legislature, allocated to the fund by the federal government and all other sums designated for deposit in the fund from any source, public or private.
(c) The fund shall be administered by the office of maternal and child health within the bureau of public health. The bureau shall file an annual report with the Joint Committee on Government and Finance describing the operation and status of the fund, acts, policies, practices or procedures of the bureau in implementing the provisions of this article, and the bureau's recommendations as to changes in law or policy which it deems necessary or appropriate.
(d) Nothing in this article may be construed or interpreted to mean that covered diagnostic and treatment services are required to be provided by the bureau or the department. Nothing in this article shall be construed to mandate funding for the breast and cervical diagnostic and treatment fund or to require any appropriation by the Legislature to the fund.
§16-33-8. Responsibilities of advisory committee; establishment of covered services, limitation of services and procedures; authorization for payment; promulgation of rules; annual reports.
(a) The advisory committee shall establish procedures and requirements regarding participation in the fund, including, but not limited to, the following:
(1) Establishing a list of covered services approved for payment through the fund, including (A) diagnostic and treatment services for breast or cervical cancer or a condition suggestive of cancer, and (B) ancillary diagnostic studies which may be authorized only when it is determined by the bureau to be directly related to the confirmation of a diagnosis of cancer or is necessary for treatment planning;
(2) Establishing procedures for emergency admissions or immediate patient entry into the health care system upon a determination that covered services are necessary so as to ensure prompt testing, diagnosis or treatment of breast or cervical cancer.
(3) Setting a limitation on days of service covered by the fund, and authorizing that the number of days for reimbursement be based on the medical condition of the patient and the procedure to be performed;
(4) Reviewing requests and providing authorization for payment of diagnostic or treatment services covered by the fund;
(5) Promulgating rules, in conjunction with the bureau, in accordance with the provisions of chapter twenty-nine-a of this code regarding the administration of the fund; and
(6) Submitting annual reports to the state bureau of public health regarding the operation and progress of the fund, the number of patients treated through the fund, and other statistical data as may be required by the bureau.
(b) The advisory committee shall study the possibility of and the cost associated with establishing a fund to provided financial assistance to qualified applicants for diagnostic and treatment services for prostate and colon cancer. The committee shall provide a report to the Joint Committee on Government and Finance on or before January 1, 1997.
To be eligible for services under the fund, a patient's income must be at or below two hundred percent of the federal poverty level in accordance with the prevailing national poverty income guidelines and be medically eligible for participation pursuant to the provisions of section ten of this article. No patient who is covered by medical insurance, Medicaid or Medicare may be financially eligible for participation in the fund.
(a) In addition to the requirements contained in section nine of this article, in order to be eligible for services under the fund, a patient shall have a condition strongly suspicious of cancer which requires diagnostic services to confirm the preliminary diagnosis to be medically eligible for diagnostic authorization. The bureau may authorize only those services determined by the advisory committee to be medically necessary to confirm a preliminary diagnosis.
(b) A positive pathology report is required before treatment services may be authorized by the fund.
(a) The bureau shall develop authorization request forms and make the forms available to the provider upon request.
(b) An application for inpatient diagnostic services shall be accompanied by a written, signed statement from the attending physician which includes the medical basis for requested inpatient services and explains why the services may not be performed on an outpatient basis.
(a) The fund is the payor of last resort. Payment for procedures shall be made at the prevailing rate established by Medicare.
(b) A claim for authorized services rendered shall be processed in accordance with rules promulgated by the bureau.