HB4840 exempts federally qualified health centers from prior authorization requirements for behavioral health services.

West Virginia HB4840 amends the Code of West Virginia to exempt federally qualified health centers from needing prior authorization for behavioral health services. This bill clarifies that these centers are not subject to the prior authorization gold card process. The exemption is subject to internal auditing and may be rescinded if the health maintenance organization determines the practitioner is not performing services in conformity with the benefit plan, identifies substantial variances in historical utilization, or identifies other anomalies.

HB4840 exempts federally qualified health centers from prior authorization requirements for behavioral health services.

West Virginia HB4840 amends the Code of West Virginia to exempt federally qualified health centers from needing prior authorization for behavioral health services. This bill clarifies that these centers are not subject to the prior authorization gold card process. The exemption is subject to internal auditing and may be rescinded if the health maintenance organization determines the practitioner is not performing services in conformity with the benefit plan, identifies substantial variances in historical utilization, or identifies other anomalies.