WEST VIRGINIA LEGISLATURJ Joint Committee on Government and Finance Aaron Allred Legislative Manager 1900 Kanawha Blvd. East' Room E-132 Charleston, WV 25305-0610 (3M) 347-4800 (304) 347-4819 FAX December 20,2017 Ms. Cynthia Beane, Commissioner \AA/ Bureau for Medical Services 350 CapitalStreet, Room 251 Charleston, \ A/ 25301 (via Email) Cynthia. E. Beane@wv.oov Dear Commissioner Beane: am writing to request that the following additional information be provided, pursuant to various requests of members of the Joint Committee on Government and Finance at the interim commiftee meeting which was previously held on Tuesday, December 5,2017 , at 1 1 :00 a.m. in Senate Finance: I 1. Information concerning the amount of money that the \ffV Bureau for Medical Services (BMS) has spent on pregnency terminations to include the past I - 10 years and if the number of pregnancy terminations have increased due to Medicaid expansion, pursuant to Delegate Miller and Delegate Cowles' request; 2. The Specific form created by DHHR that physicians use to attest that a pregnancy termination is medically necessary, pursuant to Senator Karnes' request; 3, The list of all lCD 10 Codes used for pregnancy terminations indicating those reimbursed by BMS; and 4. Information as to the number of refugees that are in the State of West Virginia, what services they are provided by BMS or other programs within DHHR, pursuant to Speaker Armstead's request. Please forward this information to me via email at: aaron.allred@wvlegislature.oov , no later than Wednesday, December 27,2017, so that it can be distributed to all members. lf you have questions, please feel free to contact me at (304) 347-4800. Si+lcerelv. U""* Uj^X Aaron Allred STATE OFWEST VIRGINTA DEPARTMENT OF HEALTH AND HUMAN R"ESOURCES BUREAU FOR MEDICAL SERVICES Jim Justice Governor Commissioneros Office Bill J' Crouch Cabinet Secretary 251 25301-3717 350 Capitol Street. Room Charlcston. West Virginia -lelephonc: (304) 55tl-1700 Fax: (304) 558-t451 January 5,2018 Aaron Allred, Legislative Manger West Virginia Legislature Joint Committee on Government and Finance Room E-132 State Capitol Complex 1900 Kanawha Boulevard, East Charleston, WV 25305 RE: Joint Committee on Government and Finance December lnterims Inquiries Dear Mr. Allred: Thank you for contacting our office regarding the Joint Committee on Government and Finance December interim committee meeting. The Bureau for Medical Services is pleased to assist your office regarding this matter. (1) Information concerning the amount of money that the VlA/ Bureau for Medical Services (BMS) has spent on pregnancy terminations to include the past 8 10 years and if the number of pregnancy terminations have increased due to Medicaid expansion, pursuant to Delegate Miller and Delegate Cowles' request; - Please see enclosed the information pertaining to pregnancy terminations from 2A0g 2017 requesfed. (2) The Specific form created by DHHR that physicians use to attest that termination is medically necessary, pursuant to senator Karnes' request; a - pregnancy Please see fhe enclosed information peftaining to the attestation form requested. (3) The list of all ICD 10 Codes used for pregnancy terminations indicating those reimbursed by BMS; and Please see the enclosed information for a list of lCD10 Codes for pregnancy terminations reimbursed by BMS. Aaron Allred January 5,2018 Page 2 (4) Information as to the number of refugees that are in the State of West Virginia, what services they are provided by BMS or other programs within DHHR, pursuant to Speaker Armstead's request. Refugees are "Qualified Non-Citizens" for purposes of Medicaid eligibility and are evaluated for eligibility under the Medicaid state plan. Refugees eligible under the state plan receive state plan medicalservices. ln 2017, it was reported that seventy-seven (77) refugee sfatus individuals received West Virginia Medicaid. We appreciate the opportunity to be of service. Please do not hesitate to reach out if you need additional information. Sincerelv., i{ itt L.t r-*J '\ a CA-\JL ,t Cynthia Beane, MSW, LCSW Commissioner Enclosure(s) cc: Bill Crouch, Cabinet Secretary, Department of Health and Human Resources WV Medicaid Preg nancy Termination Analysis SFY 2017 2016 2415 2014 2013 2012 201 1 2UA 2009 Amount Volume $326,1 03 $396 ,424 1,560 1,217 $375,310 $297,394 $278,756 $268,205 $3S+,134 $335 ,152 $302,881 763 544 502 517 630 678 677 ProviderServices - Review Project lltedical West Virginia Medicaid PO Box2254 Charleston WV 25328-2254 888 483 0793 304 348 3380 Fax *s o::st srir'- :j, fuffilflglJN* t .Ji t:i i. ..497' westVirsinia Medicaid Phys ician Gertification For Pregnancy Termination Form The Physician Certification for Pregnancy Termination Form must be completed and maintained on file at the practice location and available for review upon request by BMS and its designee Please print or type. Membeis Name Member's Medicaid Number Member's Date of Birth Member's Address I Certification of General Medical Necessity (rnust be ceriified for all claims.) I. (attending physician), having discussed this matter with the patient prior to the service, certify that on the basis of my professional judgment, this pregnancy termination was necessary in light of physical, emotional, psychological, familial or age factors (or a combination thereof) retevant to the well-being of the patient. ll Certification of Specific Medical Necessity (only if applicable,) l, (attending physician), certify that on the basis of my professional judgrnent, this pregnancy termination was medically necessary due to one or more of the following factors. (Check all that appiy) r r Pregnancy resulting from rape Pregnancy resulting from incest Endangerment of mother's life if the fetus were canied to full term Physician's Signature NPI Revised: t/27/2016 ICD 10 Codes used for pregnancy terminations reimbursed by \A/V Medicaid West Virginia Medicaid covers pregnancy terminations up to 20 weeks gestation 23A.01- Less than 8 weeks gestation of pregnancy 23A.08 234.09 23A.10 23A.11 23A.12 23A.13 - B weeks gestation of pregnancy - 9 weeks gestation of pregnancy - 10 weeks gestation of pregnancy - ll weeks gestation of pregnancy - 12 weeks gestation of pregnancy - 13 weeks gestation of pregnancy Z3AJ4 - 14 weeks gestation of pregnancy 23A.15 - 15 weeks gestation of pregnancy 2.3A.16 - 16 weeks gestation of pregnancy 23A.17 - 17 weeks gestation of pregnancy 23A.18 - 18 weeks gestation of pregnancy 23A.19 - 19 weeks gestation of pregnancy * 23A.20 20 weeks gestation of pregnancy West Virginia does NOT cover terminations after 20 weeks gestation 23A.21 21 weeks gestation of pregnancy Z3A-22 22 weeks gestation of pregnancy 23A.23 23 weeks gestation of pregnancy 23A.24 24 weeks gestation of pregnancy 23A.25 25 weeks gestation of pregnancy 23A.26 26 weeks gestation of pregnancy 23A.27 27 weeks gestation of pregnancy 23A.28 28 weeks gestation of pregnancy 23A.29 29 weeks gestation of pregnancy 234.3 Weeks of gestation of pregnancy, weeks 30-39 23A.30 30 weeks gestation of pregnancy 23A.31 31 weeks gestation of pregnancy 23A.32 32 weeks gestation of pregnancy Z3A33 33 weeks gestation of pregnancy Z3A.U 34 weeks gestation of pregnancy 23A,35 35 weeks gestation of pregnancy 23A.36 36 weeks gestation of pregnancy 23A.37 37 weeks gestation of pregnancy 23A.38 38 weeks gestation of pregnancy 23A.39 39 weeks gestation of pregnancy 23A.4 Weeks of gestation of pregnancy, weeks 40 or greater Z3A.40 40 weeks gestation of pregnancy 23A.4141 weeks gestation of pregnancy 23A.42 42 weeks gestation of pregnancy 23A.49 Greater than 42 weeks gestation of pregnancy