West Virginia Code
Article 25A. Health Maintenance Organization Act
§33-25A-8c. Third Party Payment for Child Immunization Services

Notwithstanding any provision of any policy, provision, contract, plan or agreement to which this article applies, any entity regulated by this article shall, on or after July 1, 1994, provide as benefits to all subscribers and members coverage for child immunization services as described in section five, article three, chapter sixteen of this code. This coverage will cover all costs associated with immunization, including the cost of the vaccine, if incurred by the health care provider, and all costs of vaccine administration. These services shall be exempt from any deductible, per-visit charge and/or copayment provisions which may be in force in these policies, provisions, plans, agreements or contracts. This section does not require that other health care services provided at the time of immunization be exempt from any deductible and/or copayment provisions.

Structure West Virginia Code

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-7b. Loss Ratio

§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-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-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