Senate Bill No. 366
(By Senators Kessler (Mr. President) and M. Hall,
By Request of the Executive)
[Introduced January 16, 2014; referred to the Committee on Health and Human Resources; and then to the Committee on the Judiciary.]
A BILL to amend and reenact §5-16B-1 and §5-16B-2 of the Code of West Virginia, 1931, as amended, all relating to moving the Children’s Health Insurance Program from the Department of Administration to the Department of Health and Human Resources; and providing for the orderly transfer of functions, funds and accounts.
Be it enacted by the Legislature of West Virginia:
That §5-16B-1 and §5-16B-2 of the Code of West Virginia, 1931, as amended, be amended and reenacted, all to read as follows:
ARTICLE 16B. WEST VIRGINIA CHILDREN'S HEALTH INSURANCE PROGRAM.
§5-16B-1. Expansion of health care coverage to children; creation of program; legislative directives.
(a) It is the intent of the Legislature to expand access to health services for eligible children and to pay for this coverage by using private, state and federal funds to purchase those services or purchase insurance coverage for those services. To achieve this intention, the West Virginia Children's Health Insurance Program is hereby created. The program shall be administered by the Children's Health Insurance Agency within the Department of Administration in accordance with the provisions of this article and the applicable provisions of Title XXI of the Social Security Act of 1997: Provided, That beginning on and after July 1, 2014, the agencies, boards and programs, including all of the allied, advisory, affiliated or related entities and funds, associated with the Children’s Health Insurance Program and Children’s Health Insurance Agency are incorporated in and administered as a part of the Department of Health and Human Resources. Participation in the program may be made available to families of eligible children, subject to eligibility criteria and processes to be established, which shall not create an entitlement to coverage in any person. Nothing in this article may be construed to require any appropriation of state general revenue funds for the payment of any benefit provided for in this article. In the event that this article conflicts with the requirements of federal law, federal law governs.
(b) In developing a children's health insurance program that operates with the highest degree of simplicity and governmental efficiency, the board shall avoid duplicating functions available in existing agencies and may enter into interagency agreements for the performance of specific tasks or duties at a specific or maximum contract price.
(c) In developing benefit plans, the board may consider any cost savings, administrative efficiency or other benefit to be gained by considering existing contracts for services with state health plans and negotiating modifications of those contracts to meet the needs of the program.
(d) Upon For the transfer of the functions of the Children's Health Insurance Program and the Children’s Health Insurance Agency from the department of health and human resources to the children's health insurance agency within the Department of Administration to the Department of Health and Human Resources, the Secretary of the Department of health and human resources Administration and the Secretary of the Department of administration Health and Human Resources, acting jointly, are empowered to authorize and shall authorize such transfers of program and agency funds including, but not limited to, the West Virginia Children's Health Fund created in section seven of this article and associated investment accounts; and transfers of Children's Health Insurance Program and Children’s Health Insurance Agency personnel and equipment, as are necessary, to facilitate an orderly transfer of the functions of the Children's Health Insurance Program and Children’s Health Insurance Agency. Authority to make transfers pursuant to this subsection expires on the thirty-first day of December, two thousand
(e) In order to enroll as many eligible children as possible in the program created by this article and to expedite the effective date of their health insurance coverage, the board shall develop and implement a plan whereby applications for enrollment may be taken at any primary care center or other health care provider, as determined by the director, and transmitted electronically to the program's offices for eligibility screening and other necessary processing. The board may use any funds available to it in the development and implementation of the plan, including grant funds or other private or public moneys.
As used in this article, unless the context clearly requires a different meaning:
(a) "Agency" means the Children's Health Insurance Agency; within the department of administration;
(b) "Board" means the Children's Health Insurance Program Board;
(c) "Director" means the Director of the Children's Health Insurance Agency;
(d) "Essential community health service provider" means a health care provider that:
(1) Has historically served medically needy or medically indigent patients and demonstrates a commitment to serve low-income and medically indigent populations which constitute a significant portion of its patient population or, in the case of a sole community provider, serves medically indigent patients within its medical capability; and
(2) Either waives service fees or charges fees based on a sliding scale and does not restrict access or services because of a client's financial limitations. Essential community health service provider includes, but is not limited to, community mental health centers, school health clinics, primary care centers, pediatric health clinics or rural health clinics.
(e) "Program" means the West Virginia Children's Health Insurance Program.
(NOTE: The purpose of this bill is to move the Children’s Health Insurance Program (“CHIP”) from the Department of Administration to the Department of Health and Human Resources.
Strike-throughs indicate language that would be stricken from the present law and underscoring indicates new language that would be added.)