(a) It is the intent of the Legislature to expand access to health services for eligible children and to pay for this coverage by using private, state, and federal funds to purchase those services or purchase insurance coverage for those services. To achieve this intention, the West Virginia Childrens Health Insurance Program heretofore created shall be continued and administered by the Department of Health and Human Resources, in accordance with the provisions of this article and the applicable provisions of Title XXI of the Social Security Act of 1997: Provided, That on and after July 1, 2022, the agencies, boards and programs including all of the allied, advisory, affiliated, or related entities and funds associated with the Childrens Health Insurance Program and Childrens Health Insurance Agency, shall be incorporated in and administered as a part of the Bureau for Medical Services, a division within the Department of Health and Human Resources. Participation in the program may be made available to families of eligible children, subject to eligibility criteria and processes to be established, which does not create an entitlement to coverage in any person. Nothing in this article requires any appropriation of State General Revenue Funds for the payment of any benefit provided in this article. If this article conflicts with the requirements of federal law, federal law governs.
(b) In developing a Childrens Health Insurance Program that operates with the highest degree of simplicity and governmental efficiency, the director shall avoid duplicating functions available in existing agencies and may enter into interagency agreements for the performance of specific tasks or duties at a specific or maximum contract price.
(c) In developing benefit plans, the director may consider any cost savings, administrative efficiency, or other benefit to be gained by considering existing contracts for services with state health plans and negotiating modifications of those contracts to meet the needs of the program.
(d) In order to enroll as many eligible children as possible in the program created by this article and to expedite the effective date of their health insurance coverage, the director shall develop and implement a plan whereby applications for enrollment may be taken at any primary care center or other health care provider, as determined by the director, and transmitted electronically to the programs offices for eligibility screening and other necessary processing. The director may use any funds available to the agency in the development and implementation of the plan, including grant funds or other private or public moneys.
Structure West Virginia Code
Article 16B. West Virginia Children's Health Insurance Program
§5-16B-3. Reporting Requirements
§5-16B-5. Director of the Children S Health Insurance Program; Qualifications; Powers and Duties
§5-16B-6. Financial Plans Requirements
§5-16B-6d. Modified Benefit Plan Implementation
§5-16B-6e. Coverage for Treatment of Autism Spectrum Disorders
§5-16B-7. West Virginia Children's Health Fund
§5-16B-8. Termination and Reauthorization