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OVP Health honors one family s journey to bring parity to West Virginia Medicaid | News

DHHR sued for not enforcing federal substance use disorder parity law

HUNTINGTON — A local substance use disorder treatment facility is suing the state and its contracted managed care organization for failure to enforce federal substance use disorder parity laws. In January, UniCare, the managed care organization (MCO) for West Virginia Medicaid, stopped providing reimbursements to OVP Health for urine drug screens performed in OVP Health’s in-house lab. Instead, the screens must be tested at a reference lab to get reimbursements. OVP offers medication-assisted treatment, or MAT, for substance use disorder. Along with counseling, clients must be screened before receiving their prescription. This helps staff catch relapse and weeds out patients who aren’t there to get better.

Pain doctor shows legislative impact on opioid epidemic, then has reputation questioned

Timothy Deer CHARLESTON – Tables turned as an expert witness for Cardinal Health had his professional reputation challenged during his testimony at the bellwether federal opioid trial.  Enu Mainigi, representing Cardinal Health, called local physician Timothy Deer as an expert in pain management and the standard of care for pain management.  Deer testified that he was asked to look at the standard care in West Virginia between 1994 and 2021, the change of opioid prescribing and “what really happened” in West Virginia.  Mainigi Huntington and Cabell County sued the three large distribution companies – AmerisourceBergen, Cardinal Health and McKesson – in 2017, seeking the parties be held responsible for their part in the opioid epidemic. Five of 77 pharmacies in Cabell County and Huntington, received over 23.2 million pills between 2006 and 2014 according to DEA data. 

Federal judge rules private insurance company is subject to anti-discrimination provision of Affordable Care Act

A federal judge last week ruled that The Health Plan of West Virginia is subject to compliance to a specific provision under the Affordable Care Act that prohibits sex discrimination, including transgender Americans. The Health Plan of West Virginia is a private company that provides health insurance services for the state. U.S. District Judge Robert “Chuck” Chambers on June 28 denied a motion from The Health Plan to dismiss a lawsuit from two transgender men who say their state-funded health insurance won’t cover hormone replacement therapy solely because they are transgender. Christopher Fain and Zachary Martell filed a lawsuit challenging blanket exclusions of coverage for gender-confirming health care in West Virginia’s health plans, the state’s Medicaid program and the Public Employees Insurance Agency, most commonly called PEIA, in November 2020.

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