West Virginia Code § 33-25D-18

Examinations
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(a) The commissioner may make an examination of the affairs of any prepaid limited health
service organization and providers with whom the organization has contracts, agreements or
other arrangements as often as he or she considers it necessary for the protection of the
interests of the people of this state but not less frequently than once every five years.
(b) The commissioner may contract with the Department of Human Services, any entity
which has been accredited by a nationally recognized accrediting organization and has been
approved by the commissioner to make examinations concerning the quality of health care
services of any prepaid limited health service organization and puroviders with whom the
organization has contracts, agreements or other arrangements, or any such entity
contracted with by the Department of Human Services, as oftten as it considers necessary for
the protection of the interests of the people of this state, but not less frequently than once
every five years: Provided, That in making the examination, the Department of Human
Services or the accredited entity shall utilize the services of persons or organizations with
demonstrable expertise in assessing quality of health care.
(c) Every prepaid limited health service organization and affiliated provider shall submit its
books and records to the examinations and in every way facilitate them. For the purpose of
examinations, the commissioner andg the Department of Human Services have all powers
necessary to conduct the examinations, including, but not limited to, the power to issue
subpoenas, the power to admienister oaths to and examine the officers and agents of the
prepaid limited health service organization and the principals of the providers concerning
their business. L
(d) The prepaid limited health service organization is subject to the provisions of section
nine, article two of this chapter in regard to the expense and conduct of examinations.
(e) In lieu of the examination, the commissioner may accept the report of an examination
madWe by another state.
(f) The expenses of an examination assessing quality of health care under subsection (b) of
this section and section nineteen of this article shall be reimbursed pursuant to subdivision
(5), subsection (i), section nine, article two of this chapter.

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