West Virginia Code 9-5-33 – Managed care organization contracts exempt from purchasing requirements; providing for exceptions
(a) Notwithstanding any other provision to the contrary, the Bureau for Medical Services is exempt from all requirements of the Purchasing Division, authorized under § 5A-3-1 et seq. of this code, with respect to managed care contracts: Provided, That for purposes of continuity of care, the Bureau for Medical Services may not:
Terms Used In West Virginia Code 9-5-33
- Contract: A legal written agreement that becomes binding when signed.
- Services: means nursing facility services, home and community-based services, and related hospital and prescription drug services for which an individual received Medicaid medical assistance. See West Virginia Code 9-1-2
- State: when applied to a part of the United States and not restricted by the context, includes the District of Columbia and the several territories, and the words "United States" also include the said district and territories. See West Virginia Code 2-2-10
(1) Disrupt existing WV Medicaid and WV Children’s Health Insurance Plan enrollment within an existing managed care organization as part of any such purchasing exemption; or
(2) Redistribute or reassign membership of an existing managed care organization to any new, qualifying managed care entrant as part of any contract awarded pursuant to such exemption.
The Bureau for Medical Services shall integrate any and all new and qualifying managed care entrants into the state‘s auto-assignment logic for new members and shall publicize any eligible managed care organization for purposes of self-selection by the member. No plan shall have preferential assignment of new members and each plan will be assigned equally.
(b) The Bureau for Medical Services is not exempt from the requirements of the Purchasing Division, authorized under § 5A-3-1 et seq. of this code, when soliciting a procurement for specialized populations, to include, but not be limited to, foster care.