WEST VIRGINIA CODE
WVC 5 - 16 - 12 A
§5-16-12a. Inspections; violations and penalties.
(a) Employers participating in any of the Public Employees
Insurance Agency plans shall provide, to the director, upon
request, all documentation reasonably required for the director to
discharge the responsibilities under this article. This
documentation shall include employment records sufficient to verify
actual full-time employment of the employer's employees who
participate in the Public Employees Insurance Agency plans.
(b) Upon a determination of the director or his or her
designated representative that there is probable cause to believe
that fraud, abuse or other illegal activities involving
transactions with the agency has occurred, the director or his or
her designated representative is authorized to refer the alleged
violations to the Insurance Commissioner for investigation and, if
appropriate, prosecution, pursuant to article forty-one, chapter
thirty-three of this code. For purposes of this section,
"transactions with the agency" includes, but is not limited to,
application by any insured or dependent, any employer or any type
of health care provider for payment to be made to that person or
any third party by the agency.
(c) Any person who violates any provision of this article for
which no other penalty is specifically provided is guilty of a
misdemeanor and, upon conviction thereof, is subject to a fine of
not less than $100 but not more than $500, or imprisonment for a
period of not less than twenty-four hours but not more than fifteen days, or both.
Note: WV Code updated with legislation passed through the 2015 Regular Session
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