West Virginia Code § 33-25A-5

Powers of health maintenance organizations
Open in Lexace · Ask the AI about this section
(a) Upon obtaining a certificate of authority as required under this article, a health
maintenance organization may enter into health maintenance contracts in this state and
engage in any activities, consistent with the purposes and provisions of this article, which
are necessary to the performance of its obligations under such contracts, subject to the
limitations provided in this article. A health maintenance organization may oeffer to its
enrollees in conjunction with the benefits provided to them through their contractual
arrangement for health services with the health maintenance organizatrion a point of service
option to be provided either by the health maintenance organization directly or by an
insurance carrier licensed in this state with which the health maintenance organization has a
contractual arrangement. Benefits for health care services within the health maintenance
organization's contracted provider panel shall comply with atll other provisions of this article.
(b) The commissioner shall propose rules for legislative approval in accordance with the
provisions of article three, chapter twenty-nine-a of this code limiting or regulating the
powers of health maintenance organizations which the commissioner finds to be in the
public interest. The commissioner may promuslgate emergency rules pursuant to the
provisions of section fifteen, article three, chapter twenty-nine-a of this code to implement
standards and requirements for a point of service option.

‹ Prev All West Virginia sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.