West Virginia Code
Article 15. Accident and Sickness Insurance
§33-15-19. Coordination of Benefits With Medicaid

Any health insurer, health maintenance organization as defined in article twenty-five-a of this chapter, prepaid limited health service organization as defined in article twenty-five-d of this chapter or hospital and medical service corporations as defined in article twenty-four of this chapter is prohibited from considering the availability or eligibility for medical assistance in this or any other state under 42 U.S.C. §1396a, Section 1902 of the Social Security Act, referred to in this article as Medicaid, when considering eligibility for coverage or making payments under its plan for eligible enrollees, subscribers, policyholders or certificateholders.

Structure West Virginia Code

West Virginia Code

Chapter 33. Insurance

Article 15. Accident and Sickness Insurance

§33-15-1. Scope of Article

§33-15-1a. Premium Rate Increase Requests; Loss Ratio Requirement

§33-15-1b. Rates, Individual Major Medical Policies

§33-15-2. Scope and Format of Policy

§33-15-2a. Definitions

§33-15-2b. Guaranteed Issue; Limitation of Coverage; Election; Denial of Coverage; Network Plans

§33-15-2c. Feasibility Study for Alternatives to Guaranteed Issue

§33-15-2d. Exceptions to Guaranteed Renewability

§33-15-2e. Discontinuation of Particular Type of Coverage; Uniform Termination of All Coverage; Uniform Modification of Coverage

§33-15-2f. Certification of Creditable Coverage

§33-15-2g. Applicability

§33-15-3. Age Limit

§33-15-4. Required Policy Provisions

§33-15-4a. Required Policy Provisions-Mental Illness

§33-15-4b. Policies to Cover Nursing Services; Definition

§33-15-4c. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing

§33-15-4d. Third Party Reimbursement for Rehabilitation Services

§33-15-4e. Benefits for Mothers and Newborns

§33-15-4f. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing

§33-15-4g. Required Coverage for Reconstruction Surgery Following Mastectomies

§33-15-4h. Coverage for Patient Cost of Clinical Trials

§33-15-4i. Third-Party Reimbursement for Kidney Disease Screening

§33-15-4j. Required Coverage for Dental Anesthesia Services

§33-15-4k. Maternity Coverage

§33-15-4l. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications

§33-15-4m. Eye Drop Prescription Refills

§33-15-4n. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs

§33-15-4o. Step Therapy

§33-15-4p. Lyme Disease to Be Covered by All Health Insurance Policies

§33-15-4q. Coverage for Amino Acid-Based Formulas

§33-15-4r. Substance Use Disorder

§33-15-4s. Prior Authorization

§33-15-4t. Fairness in Cost-Sharing Calculation

§33-15-4u. Mental Health Parity

§33-15-4v. Incorporation of the Health Benefit Plan Network Access and Adequacy Act

§33-15-4w. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs

§33-15-5. Optional Policy Provisions

§33-15-6. Inapplicable or Inconsistent Provisions

§33-15-7. Order of Certain Provisions

§33-15-8. Third Party Ownership of Policy Covering Insured

§33-15-9. Requirements of Other Jurisdictions

§33-15-10. Franchise Insurance

§33-15-11. Hospital Indemnity Policies Not to Exclude Coverage for Confinement in Government Hospital

§33-15-12. Continuum of Care Services

§33-15-13. Policies Not to Terminate Coverage Because of Diagnosis or Treatment of Acquired Immune Deficiency Syndrome

§33-15-14. Policies Discriminating Among Health Care Providers

§33-15-16. Policies Not to Exclude Insured's Children From Coverage; Required Services; Coordination With Other Insurance

§33-15-17. Child Immunization Services Coverage

§33-15-18. Equal Treatment of State Agency

§33-15-19. Coordination of Benefits With Medicaid

§33-15-20. Individual Medical Savings Accounts; Definitions; Ownership; Trustees; Regulations

§33-15-21. Coverage of Emergency Services

§33-15-22. Assignment of Certain Benefits in Dental Care Insurance Coverage