Division of Finance and Administration
The Division of Finance & Administration
is headed by Tina R. Bailes, Deputy Commissioner who is responsible for planning and managing the Bureau’s financial resources. Areas of responsibility include:
- The Office of Drug Rebate coordinates all activities involved in invoicing drug manufacturers for rebates for which the West Virginia Medicaid program is eligible, including tracking of drug rebate payments from drug manufacturers, reconciliation of amounts invoiced to actual payments received as well as meeting related reporting requirements. Gail J. Goodnight is the director.
- The Office of Rate Setting, Facility and Professional Services and Other Provider Fee Schedules is responsible for developing rates paid to providers for services covered by the Medicaid program. This Office is also involved in supplemental payments and provider cost settlements, as well as oversight of the third-party-liability function and is directed by Kent S. Hill.
- The Office of Budget and Accounting Services is responsible for the Bureau’s administrative and medical services budget, including cash management and claims payment activities. Also included are financial reporting, resolution of provider payment issues and coordination of financial audit activities. Stacie Haynes-Legg is the Director.
- The Office of Managed Care and Procurement Services is responsible for the administration and oversight of a risk-based managed care program, Mountain Health Trust and the Physician Assured Access System (PAAS), both of which operate under an approved 1915(b) waiver. The Bureau contracts with three MCO's for the provision of medically necessary services for approximately 165,000 Medicaid members. The Physician Assured Access System (PAAS) is designed to enhance access to medical care and to coordinate the health care needs and services of the Medicaid recipient, while managing cost and ensuring quality care. This Office is also responsible for the Bureau’s procurement activities, which are exempt from the Department of Administration’s Purchasing Division. Brandy J. Pierce is the Director.