{"data":{"id":"us-wv/w.-va.-code-33-25d-19","jurisdiction":"us-wv","citation":"W. Va. Code § 33-25D-19","heading":"Quality assurance.","body":"(a) Each prepaid limited health service organization shall have in writing a quality assurance program approved by the commissioner which describes the program's objectives, organization and problem solving activities.\n(b) The scope of the quality assurance program shall include, at a minimum:\n(1) Organizational arrangements and responsibilities for quality management and improvement processes;\n(2) A documented utilization management program;\n(3) Written policies and procedures for credentialing and recredentialing physicians and other licensed providers who fall under the scope of authority of the prepaid limited health service organization;\n(4) A written policy that addresses enrollees' rights and responsibilities;\n(5) The adoption of practice guidelines for the use of preventive health services; and\n(6) Any other criteria considered necessary by the commissioner.\n(c) This section becomes effective on May 1, 1999.","path":["CHAPTER 33. INSURANCE.","ARTICLE 25D. PREPAID LIMITED HEALTH SERVICE ORGANIZATION ACT."],"source_url":"https://code.wvlegislature.gov/33-25D-19/","current_through":"as of 2026-08-03; contains at least the enactments of the 2026 Regular Session","vintage":"","retrieved_at":"2026-09-06T00:28:44Z","sha256":"9848b8ed4de0cecdba28409abb21dcb370ade31759ca8c8d4a018446b38a2444","source_id":"us-wv","stale":true,"prev":"us-wv/w.-va.-code-33-25d-18","next":"us-wv/w.-va.-code-33-25d-20"},"notice":"GroundRules: Original legal text. Not legal advice."}