(By Delegates Perdue, Hatfield, Eldridge, Lawrence, Marshall, Perry, Poling, Rodigherio, Spencer, Susman, Border, C. Miller,

J. Miller and Rowan )

[Originating in the Committee on Health and Human Resources; Reported March 10, 2010.]

Requesting the Joint Committee on Government and Finance to conduct a study on reimbursement for medical services by preferred provider organizations.

WHEREAS, Health care in West Virginia has, as one form of payment to medical providers, managed care health insurance systems known as preferred provider organizations or networks (PPO); and
WHEREAS, Many patients are members of PPO but prefer to utilize the services of a medical provider who may not be contracted to that PPO and those providers are prevented from receiving adequate or in some cases any reimbursement from the PPO for medical services provided to those patients; and
WHEREAS, there have been numerous requests for relief from the necessity of medical providers to contract with PPO in order to receive adequate reimbursements for patients who are members of such organizations; and
WHEREAS, The issue of adequate reimbursement for West Virginia's medical providers is an important part of assuring adequate access to health care services for the people of the state; therefore be it
Resolved by the Legislature of West Virginia:
That the Joint Committee on Government and Finance is hereby requested to study the issue of reimbursement to medical providers by preferred provider organizations in this state and determine if legislative action is needed to increase access to health care in the state by regulating such reimbursement; and, be it
Further Resolved,
That the Joint Committee on Government and Finance report to the regular session of the Legislature, 2011, on its findings, conclusions and recommendations, together with drafts of any legislation necessary to effectuate its recommendations; and, be it
Further Resolved, That the expenses necessary to conduct this study, to prepare a report and to draft necessary legislation be paid from legislative appropriations to the Joint Committee on Government and Finance.