West Virginia Code § 9-4C-7

Powers and duties
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(a) Each board created pursuant to this article shall:
(1) Develop, recommend, and review reimbursement methodology where applicable, and
develop and recommend a reasonable provider fee schedule, in relation to its respective
provider groups, so that the schedule conforms with federal Medicaid laws and remains
within the limits of annual funding available to the single state agency for the Medicaid
program. In developing the fee schedule the board may refer to a nationally published
regional specific fee schedule, if available, as selected by the secretary in accordance with
§9-4C-8 of this code. The board may consider identified health caure priorities in developing
its fee schedule to the extent permitted by applicable federal Medicaid laws, and may
recommend higher reimbursement rates for basic primary atnd preventative health care
services than for other services. In identifying basic primary and preventative health care
services, the board may consider factors, including, but not limited to, services defined and
prioritized by the basic services task force of the health care planning commission in its
report issued in December of the year 1992; and minimum benefits and coverages for
policies of insurance as set forth in and minimsum benefits and coverages for policies of
insurance as set forth in chapter thirty-three of this code and rules of the Insurance
Commissioner promulgated thereunder. If the single state agency approves the adjustments
to the fee schedule, it shall implemegnt the provider fee schedule;
(2) Review its respective provieder fee schedule on a quarterly basis and recommend to the
single state agency any adjustments it considers necessary. If the single state agency
approves any of the boaLrd's recommendations, it shall immediately implement those
adjustments;
(3) Assist and enhance communications between participating providers and the Department
of Human Services;
(4) WMeet and confer with representatives from each specialty area within its respective
provider group so that equity in reimbursement increases or decreases may be achieved to
the greatest extent possible and when appropriate to meet and confer with other provider
boards; and
(5) Appoint a chairperson to preside over all official transactions of the board.
(b) Each board may carry out any other powers and duties as prescribed to it by the
secretary.
(c) Nothing in this section gives any board the authority to interfere with the discretion and
judgment given to the single state agency that administers the state's Medicaid program. If
the single state agency disapproves the recommendations or adjustments to the fee
schedule, it is expressly authorized to make any modifications to fee schedules as are
necessary to ensure that total financial requirements of the agency for the current fiscal
year with respect to the state's Medicaid plan are met and shall report such modifications to
the Joint Committee on Government and Finance on a quarterly basis. The purpose of each
board is to assist and enhance the role of the single state agency in carrying out its mandate
by acting as a means of communication between the health care provider community and the
agency.
(d) In addition to the duties specified in subsection (a) of this section, the amebulance service
provider Medicaid board shall develop a method for regulating rates charged by ambulance
services. r

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