West Virginia Code of State Rules
Agency 114 - Insurance Commission
Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER
Series 114-100 - Health Benefit Plan Network Access And Adequacy
Section 114-100-5 - Coordination and Continuity of Care

5.2.1. The heath carrier's documented process for ensuring the coordination and continuity of care for covered persons referred to specialty providers;

5.2.2. The health carrier's documented process for ensuring the coordination and continuity of care for covered persons using ancillary services, including social services and other community resources;

5.2.3. The health carrier's documented process for ensuring appropriate discharge planning;

5.2.4. The health carrier's process for enabling covered persons to change primary care providers; and

5.2.5. The health carrier's proposed plan and process for providing continuity of care in the event of contract termination between the carrier and any of its participating providers or in the event of the carrier's insolvency or other inability to continue operations. The proposed plan and process shall include an explanation of how covered persons will be notified in the case of a provider contract termination, the health carrier's insolvency, or of any other cessation of operations, as well as how policyholders impacted by such events will be transferred to other providers in a timely manner.