West Virginia Code of State Rules Agency 114A - Secretary Of DHHR; Insurance Commissioner; And Chair Of The Health Care Authority
West Virginia Code of State Rules — Agency 114A: Secretary of DHHR; Insurance Commissioner; and Chair of the Health Care Authority
Overview
Agency 114A governs the roles, responsibilities, and interrelations of three key state positions related to health and insurance in West Virginia:
The Secretary of the Department of Health and Human Resources (DHHR)
The Insurance Commissioner
The Chair of the Health Care Authority
This agency’s rules outline their duties, authorities, and procedural coordination for overseeing health services, insurance regulation, and health care planning in the state.
Purpose and Function
Coordination and Oversight
The agency establishes mechanisms to coordinate activities among the Secretary of DHHR, the Insurance Commissioner, and the Chair of the Health Care Authority to improve health services and insurance regulation.
Policy Implementation
It directs the execution of policies and programs designed to enhance public health, manage insurance markets, and guide health care infrastructure development.
Administrative Procedures
The rules specify administrative processes, reporting requirements, and interagency communications to facilitate effective governance.
Roles and Responsibilities
Secretary of DHHR
Oversees the state’s health and human services programs.
Manages service delivery to citizens, including Medicaid, public health, and social services.
Coordinates with other agencies to ensure health policy compliance and effectiveness.
Insurance Commissioner
Regulates the insurance industry within the state.
Enforces insurance laws and regulations.
Reviews and approves insurance rates, policy forms, and market conduct.
Protects consumer interests through licensing and complaint resolution.
Chair of the Health Care Authority
Leads the Health Care Authority in planning and regulating health care facilities.
Oversees health care infrastructure projects and certificate of need (CON) processes.
Ensures health care services meet the community’s needs efficiently and cost-effectively.
Key Rules and Procedures
Interagency Coordination
The agency defines protocols for collaboration, joint meetings, and information sharing among the three offices to streamline decision-making and policy alignment.
Reporting and Accountability
Regular reports on health programs, insurance market conditions, and health care facility developments must be submitted to appropriate oversight bodies.
Public Communication
Procedures ensure transparency through public notices, hearings, and stakeholder engagement, especially related to health care planning and insurance regulation.
Complaint and Appeals Process
The Insurance Commissioner administers processes for consumers to file complaints or appeals regarding insurance disputes, with clear timelines and resolution standards.
Health Care Planning and Approval
The Chair of the Health Care Authority manages rules governing the approval of new health care projects, ensuring compliance with state standards and community benefit criteria.
Enforcement and Compliance
Each office has defined authority to enforce rules within its domain, including issuing orders, imposing penalties, or requiring corrective actions.
Coordination allows for consistent enforcement across health services, insurance regulation, and health care infrastructure development.
Summary
Agency 114A establishes a framework for the Secretary of DHHR, Insurance Commissioner, and Chair of the Health Care Authority to work collaboratively in overseeing West Virginia’s health services, insurance market, and health care system development. Through coordinated governance, transparent procedures, and clear roles, the agency aims to improve health outcomes, protect consumers, and ensure efficient use of resources.
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