Senate Bill No. 203
(By Senators Hunter, Rowe, Caldwell, Unger, White and Fanning)
[Introduced January 22, 2003; referred to the Committee on
Banking and Insurance; and then to the Committee on Finance.]
A BILL to amend and reenact section one, article sixteen-b, chapter
five of the code of West Virginia, one thousand nine hundred
thirty-one, as amended, relating to expansion of health care
coverage to children; and presumptive eligibility.
Be it enacted by the Legislature of West Virginia:
That section one, article sixteen-b, chapter five of the code
of West Virginia, one thousand nine hundred thirty-one, as amended,
be amended and reenacted to read as follows:
ARTICLE 16B. WEST VIRGINIA CHILDREN'S HEALTH 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. 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.
Upon the transfer of the functions of the children's
health insurance program from the department of health and human
resources to the children's health insurance agency within the
department of administration, the secretary of the department of
health and human resources and the secretary of the department of
administration, acting jointly, are empowered to authorize and
shall authorize such transfers of program 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 personnel and
equipment, as are necessary, to facilitate an orderly transfer of
the functions of the children's health insurance program.
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: Provided, That if it appears that
a child is eligible, the family will be given card or letter
providing access to temporary health care coverage until an official eligibility determination is made. 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.
NOTE: The purpose of this bill is to expand health care
coverage to children and to provide presumptive eligibility.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would