West Virginia Code
Article 5. Miscellaneous Provisions
§9-5-19. Summary Review for Certain Behavioral Health Facilities and Services

(a) A certificate of need as provided in article two-d, chapter sixteen of this code is not required by an entity proposing additional behavioral health care services, but only to the extent necessary to gain federal approval of the Medicaid MR/DD waiver program, if a summary review is performed in accordance with the provisions of this section.
(b) Prior to initiating any summary review, the secretary shall direct the revision of the state mental health plan as required by the provisions of 42 U.S.C. 300x and section four, article one-a, chapter twenty-seven of this code. In developing those revisions, the secretary is to appoint an advisory committee composed of representatives of the associations representing providers, child care providers, physicians and advocates. The secretary shall appoint the appropriate department employees representing regulatory agencies, reimbursement agencies and oversight agencies of the behavioral health system.
(c) If the secretary of the Department of Health and Human Resources determines that specific services are needed but unavailable, he or she shall provide notice of the department's intent to develop those services. Notice may be provided through publication in the state register, publication in newspapers or a modified request for proposal as developed by the secretary.
(d) The secretary may initiate a summary review of additional behavioral health care services, but only to the extent necessary to gain federal approval of the Medicaid MR/DD waiver program, by recommending exemption from the provisions of article two-d, chapter sixteen of this code to the Health Care Authority. The recommendation is to include the following findings:
(1) That the proposed service is consistent with the state health plan and the state mental health plan;
(2) That the proposed service is consistent with the department's programmatic and fiscal plan for behavioral health services;
(3) That the proposed service contributes to providing services that prevent admission to restrictive environments or enables an individual to remain in a nonrestrictive environment;
(4) That the proposed service contributes to reducing the number of individuals admitted to inpatient or residential treatment programs or services;
(5) If applicable, that the proposed service will be community-based, locally accessible, provided in an appropriate setting consistent with the unique needs and potential of each client and his or her family and located in an area that is unserved or underserved or does not allow consumers a choice of providers; and
(6) That the secretary is determining that sufficient funds are available for the proposed service without decreasing access to or provision of existing services. The secretary may, from time to time, transfer funds pursuant to the general provisions of the budget bill.
(e) The secretary's findings required by this section shall be filed with the secretary's recommendation and appropriate documentation. If the secretary's findings are supported by the accompanying documentation, the proposal does not require a certificate of need.
(f) Any entity that does not qualify for summary review is subject to a certificate of need review.
(g) Any provider of the proposed services denied authorization to provide those services pursuant to the summary review has the right to appeal that decision to the state agency in accordance with the provisions of section ten, article two-d, chapter sixteen of this code.

Structure West Virginia Code

West Virginia Code

Chapter 9. Human Services

Article 5. Miscellaneous Provisions

§9-5-1. Exemption of Grants From Certain Taxes and Claims

§9-5-2. Release of Liens and Reassignment of Insurance Policies

§9-5-3. Recipient of Assistance Not a Pauper

§9-5-4. Penalties for False Statements, etc.

§9-5-5. Recipients of Cash Grants

§9-5-6. Attorney General and Prosecuting Attorneys to Render Legal Services to Commissioner

§9-5-7. Visitation by County Employees

§9-5-8. Authority to Examine Witnesses, Administer Oaths and Take Affidavits

§9-5-8a. Authority to Subpoena Witnesses and Documents When Investigating the Provision of Medical Assistance Programs

§9-5-8b. Authority of Investigations and Fraud Management Division to Subpoena Witnesses and Documents

§9-5-9. Direct Cremation or Direct Burial Expenses for Indigent Persons

§9-5-10. Continuation of Present Aid; Contributions by Counties

§9-5-11. Definitions; Assignment of Rights; Right of Subrogation by the Department for Third-Party Liability; Notice Requirement for Claims and Civil Actions; Notice Requirement for Settlement of Third-Party Claim; Penalty for Failure to Notify the D...

§9-5-11a. Notice of Action or Claim

§9-5-11b. Release of Information

§9-5-11c. Right of the Department of Health and Human Resources to Recover Medical Assistance

§9-5-12. Medicaid Program; Maternity and Infant Care

§9-5-12a. Medicaid Program; Dental Care

§9-5-13. Pilot Program for Certain Aid Recipients Seeking Self-Employment

§9-5-14. Medicaid Program; Health Care Facilities Financed by Bonds; Rules Regarding Reimbursement of Capital Costs

§9-5-15. Medicaid Program; Preferred Drug List and Drug Utilization Review

§9-5-16. Medicaid Program; Legislative Purpose; Health Care Provider Reimbursement Study by Department; Hearings; Report

§9-5-16a. Medicaid-Certified Nursing Homes; Screening of Applicants and Residents for Mental Illness; Reimbursement of Hospitals

§9-5-17. Nonprofit Agency or Facility, in Receipt of Medicaid Moneys, Shall Provide Annual Accounting of Gross Receipts and Disbursements Including Salaries

§9-5-19. Summary Review for Certain Behavioral Health Facilities and Services

§9-5-20. Medicaid Program; Chronic Kidney Disease; Evaluation and Classification

§9-5-21. Annual Report to Joint Committee on Government and Finance Regarding Treatment for Autism Spectrum Disorders Provided by the Bureau for Medical Services

§9-5-22. Medicaid Managed Care Reporting

§9-5-23. Bureau of Medical Services Information

§9-5-24. Requiring Substance Abuse Treatment Providers to Give Pregnant Woman Priority Access to Services

§9-5-25. Medicaid Program Compact

§9-5-26. Supplemental Medicare and Medicaid Reimbursement

§9-5-27. Transitioning Foster Care Into Managed Care

§9-5-28. Requirement for Telehealth Rates

§9-5-29. Payments to Substance Use Disorder Residential Treatment Facilities Based Upon Performance-Based Outcomes

§9-5-30. Certified Community Behavioral Health Clinics