SB 822
Revising gold card process to include hospitals or department hospitals
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- Passed Senate
- Passed House of Delegates
- To Governor
- Became Law
Bill overview
This bill revises the "gold card" process for healthcare providers in West Virginia, aiming to streamline prior authorization requirements. It expands eligibility to include hospitals and department hospitals, adjusts criteria for qualifying, extends the effectiveness period of a gold card, and establishes a standardized process for obtaining and reviewing data. The bill also increases the civil penalty for violations of prior authorization rules and allows providers to request data related to performance metrics used to determine their gold card status.
Key provisions
- Expands gold card eligibility to include hospitals and department hospitals.
- Revises criteria for qualifying for a gold card status.
- Extends the effective period of a gold card.
- Establishes a standardized gold carding process overseen by the Office of the Insurance Commissioner.
- Permits providers to request data on performance metrics used for gold card determination.
- Increases the civil penalty for violations of prior authorization requirements.
- Requires the Office of the Insurance Commissioner to provide electronic communication regarding prior authorization status.
- Mandates quarterly data reporting on prior authorizations.
Who is affected
- Healthcare providers (physicians, hospitals, and departments within hospitals)
- Health insurers
- Patients
- The West Virginia Office of the Insurance Commissioner
- Public Employees Insurance Agency
Notable changes
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