West Virginia § 33-25D-19 Quality assurance

West Virginia Statutes

§ 33-25D-19 — Quality assurance

West Virginia § 33-25D-19

Ch. 33Â INSURANCE

Art. 25DPREPAID LIMITED HEALTH SERVICE ORGANIZATION ACT

This text of West Virginia § 33-25D-19 (Quality assurance) is published on Counsel Stack Legal Research, covering West Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

W. Va. Code § 33-25D-19 (2026).

Text

(a)Each prepaid limited health service organization shall have in writing a quality assurance program approved by the commissioner which describes the program's objectives, organization and problem solving activities.

(b)The scope of the quality assurance program shall include, at a minimum:

(1)Organizational arrangements and responsibilities for quality management and improvement processes;

(2)A documented utilization management program;

(3)Written policies and procedures for credentialing and recredentialing physicians and other licensed providers who fall under the scope of authority of the prepaid limited health service organization;

(4)A written policy that addresses enrollees' rights and responsibilities;

(5)The adoption of practice guidelines for the use of preventive h

Free access — add to your briefcase to read the full text and ask questions with AI

(a) Each prepaid limited health service organization shall have in writing a quality assurance program approved by the commissioner which describes the program's objectives, organization and problem solving activities.

(b) The scope of the quality assurance program shall include, at a minimum:

(1) Organizational arrangements and responsibilities for quality management and improvement processes;

(2) A documented utilization management program;

(3) Written policies and procedures for credentialing and recredentialing physicians and other licensed providers who fall under the scope of authority of the prepaid limited health service organization;

(4) A written policy that addresses enrollees' rights and responsibilities;

(5) The adoption of practice guidelines for the use of preventive health services; and

(6) Any other criteria considered necessary by the commissioner.

(c) This section becomes effective on May 1, 1999.