§9-4D-8. Analytical criteria and reporting requirements.
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/wv/chapter-9-human-services/article-4d-medicaid-buy-in-program/9-4d-8·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(a)The secretary shall establish criteria to determine the effectiveness of the Medicaid buy-in program and continued Medicaid coverage through Section 1619 of the federal Social Security Act (42 U.S.C. §1382h). The criteria shall include an analysis of the following:
(1)The number of individuals with disabilities who are:
(A)Enrolled in the buy-in program; or
(B)Receiving Medicaid through Section 1619 of the federal Social Security Act (42 U.S.C. §1382h);
(2)The amount of state revenues resulting from premiums paid by participants in the buy-in program; and
(3)The amount of state costs incurred as a result of implementing the buy-in program, including administrative costs and costs of providing services.
(b)In addition to the criteria required under subsection
(b)of this section, the secretary may establish criteria to determine the following:
(1)Comparative costs of Medicaid funded services for participants in the buy-in program and work incentives created through Section 1619 of the federal Social Security Act (42 U.S.C. §1382h) before and after employment;
(2)The number of supplemental security income and social security disability insurance recipients in West Virginia who are no longer dependent on, or who have reduced dependence on, public assistance or health care entitlement services, other than Medicaid or the Children's Health Insurance Program, due to participation in the buy-in program or work incentives created through Section 1619 of the federal Social Security Act (42 U.S.C. §1382h);
(3)The number of individuals with severe disabilities who are no longer dependent on, or who have reduced dependence on, public benefits or services, other than Medicaid or the Children's Health Insurance Program, due to income or support services received through participation in the buy-in program or work incentives created through Section 1619 of the federal Social Security Act (42 U.S.C. §1382h); and
(4)The change in the number of buy-in program participants or participants in work incentives created through Section 1619 of the federal Social Security Act (42 U.S.C. §1382h) who have health care needs and related services covered through employer based benefit programs.
(c)In evaluating the effectiveness of the state's work incentives initiatives for individuals with disabilities, the secretary:
(1)Shall collaborate with other state agencies on data collection; and
(2)May consult with an independent contractor to collect data on the criteria required by this section.
(d)The department secretary shall provide an annual report of its evaluation of the Medicaid buy-in program performed pursuant to the requirements of this section to the Legislature no later than the last day of December of each year, beginning in two thousand four.