Senate Bill No. 670
(By Senator Kessler)
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[Introduced March 23, 2009; referred to the Committee on the
Judiciary; and then to the Committee on Finance.]
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A BILL to amend and reenact §49-7-33 of the Code of West Virginia,
1931, as amended, relating to the court-ordered payment of
medical or socially necessary services for children by the
Department of Health and Human Resources; excluding expert
fees and expenses associated with testifying; defining medical
services and socially necessary services; and establishing a
fee schedule for non-Medicaid approved providers.
Be it enacted by the Legislature of West Virginia:
That §49-7-33 of the Code of West Virginia, 1931, as amended,
be amended and reenacted to read as follows:
ARTICLE 7. 670GENERAL PROVISIONS.
§49-7-33. Payment of services.
(a) At any time during any proceedings brought pursuant to
articles five and six of this chapter, the court may upon its own
motion, or upon a motion of any party, order the West Virginia Department of Health and Human Resources to pay for
professional
medical or socially necessary services rendered by a psychologist,
psychiatrist, physician, therapist,
or other health care
professional
or service provider to a child or other party to the
proceedings.
Professional Medical services include, but are not
limited to, treatment, therapy, counseling, evaluation, report
preparation, consultation and preparation of expert testimony,
excluding an expert's fee and expenses entailed in his or her
appearance and providing testimony as a witness. Socially
necessary services are nonhealth care intervention services
provided to a child or family and include, but are not limited to,
family support services, family preservation services, foster care
services, adoption preservation services and family reunification
services. The West Virginia Department of Health and Human
Resources shall set the fee schedule for
such the services in
accordance with the Medicaid rate, if any, or
establish the
customary rate
of the service and adjust the schedule as
appropriate. Every such psychologist, psychiatrist, physician,
therapist,
or other health care professional,
or service provider,
including out-of-state providers, providing service shall be paid
by the West Virginia Department of Health and Human Resources upon
completion of services and submission of a final report or other
information and documentation as required by the policies and
procedures implemented by the West Virginia Department of Health and Human Resources.
(b) Any individual or entity providing services pursuant to a
court order, including an out-of-state provider, who is not a
Medicaid approved provider or any other approved provider of the
Department of Health and Human Resources, shall be paid no more
than the state's share of the costs if the service qualifies as a
Medicaid reimbursable service, or at the established rate set by
the Department of Health and Human Resources if the costs are not
reimbursed by Medicaid.
(c) The provisions of this article do not confer or mandate
Medicaid eligibility, coverage or provider enrollment that does not
conform with Title XIX of the Social Security Act, the Medicaid
state plan and applicable rules and policies. Further, nothing in
the provisions of this article confer or mandate socially necessary
services eligibility, coverage or provider enrollment that does not
conform to policies and procedures established by the Department of
Health and Human Resources.
NOTE: The purpose of this bill is to expand the definition of
court-ordered services for children for which the Department of
Health and Human Resources required to pay to include socially
necessary services. The bill also addresses the payment for
services rendered, and would prevent nonMedicaid approved providers
from seeking payments above the Medicaid rate or the established
rate set by the Department of Health and Human Resources.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.
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