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2021 West Virginia Code
Chapter 33. Insurance
Article 25A. Health Maintenance Organization Act
- §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-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-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. Repealed. Acts, 2005 Reg. sess., Ch. 143
- §33-25A-24b. Repealed. Acts, 2005 Reg. sess., Ch. 143
- §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. Repealed. Acts, 2005 Reg. sess., Ch. 143
- §33-25A-30. Repealed. Acts, 2005 Reg. sess., Ch. 143
- §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
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