West Virginia Code § 33-15E-10

Provider agreements; provider listing requirements
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(a) (1) A discount medical plan organization shall have a written provider agreement with all
providers offering medical or ancillary services to its members. The written provider
agreement may be entered into directly with the provider or indirectly with a provider
network to which the provider belongs.
(2) A provider agreement between a discount medical plan organization and a provider shall
provide the following:
(A) A list of the medical or ancillary services and products to be uprovided at a discount;
(B) The amount or amounts of the discounts or, alternatively, a fee schedule that reflects the
provider's discounted rates; and
(C) A written document demonstrating that the provider has agreed that it will not charge
members more than the discounted rates. l
(3) A provider agreement between a discount medical plan organization and a provider
network shall require that the provider network have written agreements with its providers
that:
(A) Contain the provisions described in subdivision (2) of this subsection;
(B) Authorize the provider network to contract with the discount medical plan organization
on behalf of the provideLr; and
(C) Require the provider network to maintain an up-to-date list of its contracted providers
and to provide the list on a monthly basis to the discount medical plan organization.
(4) A provider agreement between a discount medical plan organization and an entity that
conWtracts with a provider network shall require that the entity, in its contract with the
provider network, require the provider network to have written agreements with its
providers that comply with subdivision (3) of this subsection.
(5) The discount medical plan organization shall maintain a copy of each of its active
provider agreements; each such organization shall also retain a copy of every inactive
provider agreement for at least two years after the expiration date of each such agreement.
(b) Each discount medical plan organization shall maintain on its Internet website page a
current list of the names and addresses of the providers with which it has contracted directly
or through a provider network; the address of the website shall be prominently displayed on
all of the discount medical plan organization's advertisements, marketing materials,
brochures and discount medical plan cards.

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