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Medicaid Services Fund Advisory Council

In 1953, the West Virginia Legislature created an advisory council to provide advice in the following three areas:

  1. The Medical Services Fund

  2. Disbursements from the Fund

  3. Health and Medical Services

Medical expenses of Medicaid eligible clients are paid from the Medical Services Fund.  Code of Federal Regulations 42, Section 431.12 requires that states form committees to advise Medicaid agencies in West Virginia's case of the Bureau for Medical Services about health and medical care services.  In addition to State and Federal law, case law requires Medicaid officials to consult the Advisory Council before certain policies are adopted [Dunn v. Ginsberg, USDC, Southern District, WV]. The Council pre-existed Medicaid which was created as Title XIX of the Social Security Act of 1965. Without the Council the state would be in noncompliance with the State Medicaid Plan and federal Medicaid funds could be in jeopardy.

The Council is organized under the Bureau for Medical Services within the Department of Health and Human Resources. Nine to thirteen members, four of which are ex officio, are permitted to serve. The four ex officios are the heads of public health (Bureau for Public Health), welfare (Bureau for Children and Families) and the cochairs of the Legislative Oversight Commission on Health and Human Resources Accountability. Appointed members serve staggered terms, ranging from one to four years, until they are reappointed or replaced by the Commissioner of the Bureau for Medical Services. Members meet quarterly or at the call of the Bureau for Medical Services and are permitted reimbursement of reasonable and necessary travel expenses for days served attending meetings.

Medicaid Expansion Numbers by County

WV Medicaid MAGI Count by County

 

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