H. B. 2066
(By Delegate Farris)
[Introduced February 13, 1997; referred to the
Committee on Health and Human Resources then Government Organization.]
A Bill to amend and reenact section three-b, article sixteen, chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, relating to requiring the state licensing of home health care agencies; requiring the department of health and human resources to provide for such licensing; and providing that licensing requirements be reasonable and in accordance with the specific coverages set forth by this section relative to services, treatments or other assistance rendered by any home health care agency.
Be it enacted by the Legislature of West Virginia:
That section three-b, article sixteen, chapter thirty-three of the code of West Virginia, one thousand nine hundred
thirty-one, as amended, be amended and reenacted to read as
follows:
Article 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-3b. Home health care coverage.
(a) Any insurer who, on or after the first day of January,
one thousand nine hundred eighty-one, delivers or issues for
delivery in this state group basic hospital expense or major
medical expense coverage under this article shall make available
to the policyholder home health care coverage consistent with the
provisions of this section. For purposes of this section, "home
health care" means health services provided by a home health
agency certified in the state in which the home health services
are delivered or under Title XVIII of the Social Security Act:
Provided, That any home health agency rendering services in this
state shall be licensed in accordance with the reasonable
requirements of the department of health and human resources. The department of health and human resources is hereby directed
to propose rules prescribing reasonable requirements that upon
legislative approval, shall be complied with before any home
health agency may be issued a license. These requirements shall
issue in accordance with the requirements of this section
regarding inclusions of coverage and shall set forth basic
minimum standards regarding the provision of any service,
treatment or other assistance specified as being covered
hereunder.
(b) Home health care coverage offered shall include:
(1) Services provided by a registered nurse or a licensed
practical nurse;
(2) Health services provided by physical, occupational,
respiratory and speech therapists;
(3) Health services provided by a home health aide to the
extent that such services would be covered if provided to the
insured on an inpatient basis;
(4) Medical supplies, drugs, medicines and laboratory
services to the extent that they would be covered if provided to
the insured on an inpatient basis; and
(5) Services provided by a licensed midwife or a licensed
nurse midwife as these occupations are defined in section one,
article fifteen, chapter thirty of the code.
(c) Home health care coverage may be limited to:
(1) Services provided on the written order of a licensed
physician, provided such order is renewed at least every sixty
days;
(2) Services provided, directly or through contractual
agreements, by a home health agency certified in the state in
which the home health services are rendered or under Title XVIII
of the Social Security Act; and
(3) Services as set forth in subsection (b) of this section
without which the insured would have to be hospitalized.
(d) Coverage under this section shall be provided for at
least one hundred home visits per insured per policy year, with
each home visit by a member of a home health care team to be
considered as one home health care visit including up to four
hours of home health care services.
(e) No such policy need provide such coverage to persons
eligible for medicare.
NOTE: The purpose of this bill is to require the licensing
of home health care agencies by this state.
Strike-throughs indicate language that would be stricken
from the present law, and underscoring indicates new language
that would be added.