WVC 33 -
CHAPTER 33. INSURANCE.
WVC 33 - 42 -
ARTICLE 42. WOMEN'S ACCESS TO HEALTH CARE ACT.
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§33-42-1. Short title.
This article shall be known and may be cited as the "Women's
Access To Health Care Act."
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§33-42-2. Legislative findings and purpose.
The Legislature finds and declares that adequate delivery of
health care services to women requires direct access to primary and
preventative obstetrical and gynecological services, which services
may be provided as "well woman examinations", direct access without
prior authorization to prenatal and obstetrical services for
pregnant women and access to certain services essential to the
physical and psychological integrity of women.
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For purposes of this article:
(1) "Advanced nurse practitioner" means a certified
nurse-midwife, or an advanced nurse practitioner certified to
practice in family practice, women's health (ob/gyn), or primary
care adult, geriatric or pediatric practice, practicing within the
lawful scope of that provider's practice.
(2) "Health benefits 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, when the policy or plan covers hospital, medical or
(3) "Partial-birth abortion" means an abortion in which the
person performing the abortion partially vaginally delivers a
living fetus before killing the fetus and completing the delivery.
(4) "Physician performing a partial-birth abortion" means a
doctor of medicine or osteopathy legally authorized to practice
medicine and surgery in West Virginia, or any other individual who
is legally authorized by the state to perform abortions: Provided, That any individual who is not a physician or not otherwise legally
authorized by the state to perform abortions, but who nevertheless
directly performs a partial-birth abortion, is subject to the
provisions of this article.
(5) "Vaginally delivers a living fetus before killing the
fetus" means deliberately and intentionally delivering into the
vagina a living fetus, or a substantial portion thereof, for the
purpose of performing a procedure that the physician or person
delivering the living fetus knows will kill the fetus, and kills
(6) "Women's health care provider" means an obstetrician/
gynecologist, advanced nurse practitioner certified to practice in
women's health (ob/gyn), certified nurse-midwife or physician
assistant-midwife practicing within the lawful scope of that
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§33-42-4. Limitations on conditions of coverage.
No health benefits policy may require as a condition to the
coverage of basic primary and preventative obstetrical and
gynecological services that a woman first obtain a referral from a
primary care physician: Provided
, That for a health maintenance
organization authorized under article twenty-five-a of this
chapter, direct access, at least annually, to a women's health care
provider for purposes of a well woman examination shall satisfy the
foregoing requirement. No health benefits policy may require as a
condition to the coverage of prenatal or obstetrical care that a
woman first obtain a referral for those services by a primary care
physician. No health benefits policy providing coverage for
surgical services in a hospital inpatient or outpatient setting may
deny coverage for: (1) Reconstruction of the breast following
mastectomy; or (2) reconstructive or cosmetic surgery required as
a result of an injury caused by an act of family violence as
defined in section three, article two-a, chapter forty-eight of
this code, when the person inflicting the injury was convicted of
a felony, a lesser included misdemeanor offense, or a charge of
domestic battery for inflicting the injury.
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§33-42-5. 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-eight, 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 services.
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§33-42-6. 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.
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§33-42-7. 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.
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§33-42-8. Partial-birth abortions prohibited; criminal penalties;
exceptions; hearings by state board of medicine.
(a) Any person who knowingly performs a partial-birth abortion
and thereby kills a human fetus is guilty of a felony and shall be
fined not less than ten thousand dollars, nor more than fifty
thousand dollars, or imprisoned not more than two years, or
both fined and imprisoned. This section does not apply to a
partial-birth abortion that is necessary to save the life of a
mother when her life is endangered by a physical disorder, illness
(b) A physician charged pursuant to this section may seek a
hearing before the West Virginia board of medicine on the issue of
whether the physician's act was necessary to save the life of a
mother pursuant to the provisions of subsection (a) of this
section. The findings of the board of medicine are admissible on
this issue at the trial of the physician. Upon a motion by the
defendant, the court shall delay the beginning of trial for not
more than thirty days to permit the board of medicine hearing to
(c) No woman may be prosecuted under the provisions of this
section for having a partial-birth abortion, nor may she be
prosecuted for conspiring to violate the provisions of this