W. Va. Code R. § 85-28-4

Current through Register Vol. XLI, No. 35, August 30, 2024
Section 85-28-4 - Suspension or Termination
4.1. Consultation. The Executive Director shall consult with any of the following medical experts for purposes of determining whether a health care provider should be suspended or terminated pursuant to W. Va. Code Section § 23-4-3c:
(1) Medical experts in the Workers' Compensation Commission's Office of Medical Services, including the Director or Associate Director;
(2) The Health Care Advisory Panel, or one or more of its members; or
(3) Any other medical expert selected by the Executive Director, in his or her sole discretion.
4.2. Notification. When the Commission determines that there is probable cause to believe that a health care provider should be suspended or terminated under the provisions of W. Va. Code §23-4-3c, the Commission may proceed with the suspension or termination and shall thereafter provide written notice to the health care provider by United States mail, first class, postage pre-paid.
4.2.a. The written notice shall state the nature of the charges against the health care provider and the action taken or to be taken by the Commission.
4.2.b. The written notice shall state a time and place at which the health care provider shall appear to show cause why its right to receive payment from the Workers' Compensation Commission for treatment of injured workers under W. Va. Code § 23-1-1 et seq. should not have been or should not be suspended or terminated.
4.2.c. The written notice shall inform the health care provider that it is afforded the opportunity to review the Commission's evidence, to cross-examine the Commission's witnesses, and to present testimony and evidence in support of its position.
4.3. Final decision. Each notification of suspension or termination shall be considered a final decision of the Commission.

W. Va. Code R. § 85-28-4