W. Va. Code R. § 85-21-11

Current through Register Vol. XLI, No. 40, October 4, 2024

Section 85-21-11 - Reporting Requirements

11.1. Each certified managed health care plan shall submit a report to the Commission or upon termination of the Commission, the insurance commissioner, semi-annually containing the following information:

a. Number of employees treated by the managed care plan;

b. Number of work-related injuries or diseases by ICD-9 code treated under the managed care plan in the preceding year;

c. Breakdown by ICD-9 codes of injuries and diseases treated;

d. Total medical costs;

e. Average medical cost per injured employee by type of injury;

f. Average medical cost per diseased employee by type of disease;

g. Breakdown of medical cost elements as to type of physician utilized, hospital costs, drug costs, and other costs;

h. Number of grievances filed, and summary of action taken; and

i. Number of days by type of injury and disease for which an employee has been released from work.

W. Va. Code R. § 85-21-11