§5-16-12a. Inspections; violations and penalties

Published: 2015

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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

The WV Code Online is an unofficial copy of the annotated WV Code, provided as a convenience. It has NOT been edited for publication, and is not in any way official or authoritative.