BMS_ManCare


Office of Medicaid Managed Care



Mountain Health Trust Carelink Health Plans Health Plan of the Upper Ohio Valley Unicare Managed Care Expansion Map Click here for a color coded state map of HMO availability.	The Bureau for Medical Services (BMS), Office of Medicaid Managed Care, initiated a risk-based managed care program for certain groups of Medicaid recipients in September 1996. Under this program, the Bureau has contracts with three HMOs for the provision of medically necessary services currently provided by the State, with the exception, most notably, of behavioral health, pharmacy, long term care, and non-emergency medical transportation services. The HMOs under contract with BMS are Carelink Health Plans, The Health Plan of the Upper Ohio Valley , and Unicare. The name of the program is Mountain Health Trust. Mountain Health Trust is continuing to enroll AFDC, AFDC-related, and certain qualified women and children in a 47 county area, followed later with separate enrollment phase-in of SSI recipients in those counties. There are approximately 130,000 members enrolled in Mountain Health Trust. To see which counties the HMOs are currently operating in; please click the link on this page to be directed to the Managed Care Expansion Map.

Physician Assured Access System (PAAS) top of page Automated Health Systems Inc. PAAS Provider Agreement PAAS Referral Form	West Virginia has operated the Physician Assured Access System (PAAS) program under a 1915(b) waiver from CMS since 1992. Currently, there are approximately 100,000 Medicaid recipients enrolled in the program, representing approximately 37% of the total West Virginia Medicaid population. The design of the program is formulated to enhance access to medical care and to coordinate the health care needs and services of the Medicaid recipient, while managing cost and ensuring quality care. Through assigning responsibility for coordination and continuity of care to a primary provider who accepts the responsibility of directing all aspects of patient care, the patient-provider relationship is formed and a medical home is established. The State hopes to achieve desired levels of access, quality, cost savings and satisfaction. A contracted Health Benefits Manager performs recipient education and enrollment for PAAS and Mountain Health Trust. Automated Health Systems, Inc., (1-800-449-8466), is based in the Charleston area and has field staff in all WV counties.

Office of Managed Care / 350 Capitol Street Room 251 / Charleston, WV 25301-3709