These administrative policies apply to the West Virginia Marketplace plans.
Administrative policies offer guidance on determination of medical necessity, investigation and experimental services.
The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.
Current Administrative Policies
- Medical Necessity - Off Label
- Medical Necessity Determinations
- Medical Necessity for Medical Benefit Medications
- Medical Necessity for Non-Formulary Medications
- Medical Record Documentation Standards for Practitioners
- Methadone Treatment Providers
- Molecular Diagnostics Testing
- Multi-ingredient Compound Policy