West Virginia

- West Virginia became the first state to pass DPC related legislation largely due to the efforts of Vic Wood, DO who faced threats of legal action from an aggressive insurance commissioner. The legislation was originally enacted as a three year pilot program in 2006 and set to expire in June of 2011.  The pilot clinics that began under the program continued to operate after the expiry date, and in 2013 with the passage of Senate Bill 557 the program was renewed with a new expiration date of June 30, 2016.  For the text of the law see the West Virginia Code  §16-2J-1.  More details can be found on the application page of the West Virginia Health Care Authority (the same entity in charge of West Virginia's certificate of need laws).

- This is probably the worst state legislation passed to date for multiple reasons (although Oregon's is not much better):

  • The Insurance Commissioner and the Health Care Authority are responsible for the regulatory oversight of the pilot project.
  • DPC practices face severe reporting obligations
  • Severe marketing restrictions apply (you may only market to those that you know have a "high deductible plan" or those that are uninsured - you are in violation if you attempt to present DPC as a viable alternative to those already possessing traditional insurance)
  • Scope of practiced is narrowed by the Health Care Authority
  • Price setting - the Health Care Authority may approve or disapprove of your monthly charges
  • A separate license is needed from the Health Care Authority to participate in the Preventive Care Pilot Program

- If you want to practice as a DPC physician in West Virginia you should take note of the sad state of the Preventive Care Pilot Program.  If you can tolerate participating in the program then you should be safe from the insurance commissioner.  Those attempting to run a traditional DPC practice may quickly find that it makes more sense to avoid participating in the Preventive Care Pilot Program altogether, meaning that you may well face the same insurance commissioner threats that Vic Wood encountered years ago.  Be certain that you closely review West Virginia Code Chapter 33 Insurance.  

- For a detailed analysis of the law please see my article in the West Virginia Medical Journal comparing West Virginia and Washington DPC laws (the first two states to pass DPC legislation).  A link (open access) to the March / April 2014 edition can be found here.  The manuscript appears on pages 8-11.  

- Dr. Eskew is a family physician that started his medical training in West Virginia, and he is often asked why he did not return to the state.  In this manuscript in the West Virginia Medical Journal he explains some of the reasons he chose to move to Wyoming.  

Why this West Virginia Trained Physician Moved to Wyoming, Eskew, P.  WV J Med, 2015;111(6):8-9. 
(Available open-access online via the West Virginia Medical Journal website)

- Three DPC practices are already known to be operating within West Virginia Preventive Care Pilot Program.  Vic Wood's practice, Primary Care One, continues to participate in the program.