H. B. 2431
(By Mr. Speaker, Mr. Kiss, and Delegates
Williams, Douglas, Fleischauer,
[Introduced January 14, 1998; referred to the
Committee on Banking and Insurance then Government Organization.]
A BILL to amend chapter thirty-three of the code of West
Virginia, one thousand nine hundred thirty-one, as amended,
by adding thereto a new article, designated article
forty-one, relating to women's access to health care;
enacting the "Women's Access To Health Care Act"; defining
terms; stating legislative findings and purpose; requiring
providers of health benefits policies to provide coverage
for direct access to women's health care providers and
specified services without referral or additional
deductibles or copayments; requiring disclosure of female
enrollees' rights to direct access to certain health care
services, disclosure of certain exclusions from coverage,
and disclosure of right to limit coverage to medically
necessary and appropriate services; prohibiting certain
cost-sharing; permitting limitations on the number of women's health care providers in a network under certain
conditions; providing a short title; and providing for an
Be it enacted by the Legislature of West Virginia:
That chapter thirty-three of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, be amended by
adding thereto a new article, designated article forty-one, to
read as follows:
ARTICLE 41. WOMEN'S ACCESS TO HEALTH CARE ACT.
§33-41-1. General provisions.
For purposes of this article:
(1) "Women's health care provider" means an
obstetrician/gynecologist or certified nurse-midwife practicing
within the lawful scope of a health care practice that is devoted
to providing health care services to women throughout their
(2) "Health benefit policy" means any individual or group
plan, policy or contract for health care services issued,
delivered, issued for delivery, or renewed in this state by a
health care corporation, health maintenance organization,
accident and sickness insurer, fraternal benefit society,
nonprofit hospital service corporation, nonprofit medical service
corporation or similar entity.
§33-41-2. Legislative findings and purpose.
The Legislature of West Virginia hereby finds and declares
that delivery of health care services for women has been proven
to be variable from that of men and, in consequence thereof,
enacts this article with the purpose of providing for the
improved delivery and accessibility of health care services to
women in this state.
§33-41-3. Required coverage.
No health benefits policy that covers hospital, medical or
surgical expenses may require as a condition to the coverage of
the services of a women's health care provider that an enrollee,
subscriber or insured first obtain a referral from another
physician. Services covered by this section are limited to those
services specified in the published recommendation of the
accreditation council for graduate medical education for training
as an obstetrician/gynecologist for physicians or the American
college of nurse-midwives' core competencies for nurse-midwives.
These services include diagnosis, treatment and referral.
§33-41-4. Required disclosure.
Every health benefits policy that is issued, delivered, issued
for delivery or renewed in this state on or after the first day
of July, one thousand nine hundred ninety-seven, shall disclose
in writing to enrollees, subscribers and insureds, in clear and accurate language, the female enrollee's right of direct access
to a women's health care provider of her choice. The information
required to be disclosed shall include, at a minimum, any
specific women's health care services that are excluded from
coverage and the health benefits policy's right to limit coverage
to medically necessary and appropriate women's health care
§33-41-5. Certain cost-sharing prohibited.
No health benefits policy may impose additional copayments or
deductibles for female enrollees' direct access to in-network,
participating women's health care providers unless the same
additional cost-sharing is imposed for other types of health care
services not delineated in this article.
§33-41-6. Limitation on number of women's health care providers.
A health benefits policy may limit the number of women's
health care providers in a network: Provided, That a sufficient
number of providers are available to serve a defined population
or geographic service area so that female enrollees will have
direct and timely access to women's health care providers.
§33-41-7. Short title.
This article may be known and shall be cited as the "Women's
Access To Health Care Act."
NOTE: The purpose of this bill is to enact the Women's Access
to Health Care Act.
This article is new; therefore, strike-throughs and
underscoring have been omitted.