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West Virginia Medicaid claim payments to be affected by state deficit

April 25, 2016
FROM:     Cynthia E. Beane, Acting Commisioner, State of West Virginia, Department of Heath and Human Resources, Bureau for Medical Services
TO:         Medicaid Providers
RE:         Unable to Process Claims at the Same Consistent Level

"As you are aware, the state faces a significant deficit for fiscal year 2016 which is also projected to continue into fiscal year 2017. Absent an upward trend in revenues or a funding solution identified, the Bureau for Medical Services (BMS) will be unable to continue to process claims at the same consistent level that has been maintained. Every effort will be made to effectuate the least amount of harm to providers, analyzing claims on a weekly basis and projecting future weeks against anticipated funds availability. It is also important to note that if actual expenditure levels differ significantly from estimated levels this could furthernegatively impact cash flow.

We realize that the services you provide are critical to our citizens and as such wanted to make you aware of the issues the state faces in hope that information will assist you with planning to mitigate the impact this may have to your operations."

Cynthia E. Beane, MSW, LCSW Acting Commissioner 

Guaranteed cash flow during transition.