Gold Card StatePA Reform Enacted
West Virginia Prior Authorization Requirements
A guide to prior authorization rules, turnaround times, and laws for medical practices operating in West Virginia (WV).
PA Turnaround Times
Standard Requests
14 calendar days
Urgent / Expedited
72 hours
Gold Card Law
West Virginia enacted gold card legislation allowing PA exemptions for providers with demonstrated high approval rates.
PA Reform Legislation
West Virginia has enacted PA reform including gold card provisions.
Key Regulations
- Gold card exemption for high-performing providers
- Standard PA turnaround of 14 calendar days
- Urgent requests within 72 hours
West Virginia Medicaid PA
West Virginia Medicaid uses managed care. PA administered by MCOs.
Recent Changes (2025-2026)
- Gold card legislation implementation
Top Payers in West Virginia
Highmark Blue Cross Blue Shield West VirginiaThe Health PlanUnitedHealthcare
State Regulatory Body: West Virginia Offices of the Insurance Commissioner
File PA complaints or appeals through your state insurance department.
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