(a) Any insurer who, on or after January 1, 1984, delivers or issues a policy of group accident and sickness insurance in this state under the provisions of this article shall make available as benefits to all subscribers and members coverage for primary health care nursing services as defined in section four-b, article fifteen of this chapter, if such services are currently being reimbursed when rendered by any other duly licensed health care practitioner. No insurer may be required to pay for duplicative health care services actually provided by both a registered professional nurse or licensed midwife and other health providers.
(b) Nothing in this section may be construed to permit any registered professional nurse licensee or midwife licensee to perform professional services beyond such individual's areas of professional competence as established by education, training and experience.
Structure West Virginia Code
Article 16. Group Accident and Sickness Insurance
§33-16-3. Required Policy Provisions
§33-16-3b. Home Health Care Coverage
§33-16-3bb. Coverage for Amino Acid-Based Formulas
§33-16-3cc. Substance Use Disorder
§33-16-3d. Medicare Supplement Insurance
§33-16-3dd. Prior Authorization
§33-16-3e. Policies to Cover Nursing Services
§33-16-3ee. Fairness in Cost-Sharing Calculation
§33-16-3ff. Mental Health Parity
§33-16-3g. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing
§33-16-3gg. Incorporation of the Health Benefit Plan Network Access and Adequacy Act
§33-16-3h. Third Party Reimbursement for Rehabilitation Services
§33-16-3hh. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-16-3i. Coverage of Emergency Services
§33-16-3j. Hospital Benefits for Mothers and Newborns
§33-16-3k. Limitations on Preexisting Condition Exclusions for Health Benefit Plans
§33-16-3l. Renewability and Modification of Health Benefit Plans
§33-16-3m. Creditable Coverage
§33-16-3n. Eligibility for Enrollment
§33-16-3o. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-16-3p. Required Coverage for Reconstruction Surgery Following Mastectomies
§33-16-3q. Required Use of Mail-Order Pharmacy Prohibited
§33-16-3r. Coverage for Patient Cost of Clinical Trials
§33-16-3s. Third-Party Reimbursement for Kidney Disease Screening
§33-16-3t. Required Coverage for Dental Anesthesia Services
§33-16-3u. Special Enrollment Period Under the American Recovery and Reinvestment Act of 2009
§33-16-3v. Required Coverage for Treatment of Autism Spectrum Disorders
§33-16-3x. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-16-3y. Eye Drop Prescription Refills
§33-16-3z. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-16-3zz. Lyme Disease to Be Covered by All Health Insurance Policies
§33-16-5. Contingencies for Which Benefits or Reimbursement of Expenses Permitted
§33-16-6. Rider Changing Individual Policy to Group Policy Prohibited
§33-16-7. Hospital Indemnity Policies Not to Exclude Coverage for Confinement in Government Hospital
§33-16-8. Continuum of Care Services
§33-16-10. Policies Discriminating Among Health Care Providers
§33-16-12. Child Immunization Services Coverage
§33-16-13. Equal Treatment of State Agency
§33-16-14. Coordination of Benefits With Medicaid
§33-16-16. Insurance for Diabetics
§33-16-17. Commissioner to Propose Rules
§33-16-18. Assignment of Certain Benefits in Dental Care Insurance Coverage