West Virginia

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Medical program

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Long Term Care Programs: A&D Waiver, I/DD Waiver, TBI Waiver, Nursing Home PAS, Personal Care

Please check back as we update our site as new materials become available.

APS-West Virginia provides comprehensive healthcare management and consultation to WV Department of Health and Human Resources (DHHR). Through this partnership model, APS Healthcare conducts administrative, clinical and coordinating activities for the Bureau for Medical Services, Bureau for Children & Families and the Bureau for Behavioral Health & Health Facilities that result in a more effective and efficient system of care for West Virginia.

As the Administrative Services Organization (ASO), APS assists the West Virginia Department of Health and Human Resources (DHHR) in its development and management of a high quality, accountable, public sector system for an array of programs that include: behavioral health, medical, socially necessary, nursing home pre-admission screening, long term care, Aged & Disabled Waiver and Intellectual/Developmental Disability (I/DD) Waiver.

The APS-WV program includes, but is not limited to, the following functions:

  • An effective and efficient process of utilization management
  • An established training and consultative process (retro reviews) that encourages
    • Improvement in the quality of care;
    • Ensuring that care is provided in the most appropriate setting; and
    • Increasing successful outcomes.
  • Provision of education and technical assistance to providers
  • Provision of consumer education which has included
    • Annual focus groups;
    • Family support and education; and
    • Specialized trainings such as Consumer Rights/Responsibilities.

For more information, please call APS - West Virginia at 800-461-0655.

New Health Home Materials New

Click here to learn more

FQHC and RHC Providers

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Aged and Disabled Waiver Program (ADW)

Click here to learn more

Fax number changes!!

Traumatic Brain Injury (TBI) Waiver Services

The WV Medicaid Traumatic Brain Injury (TBI) Waiver went into effect February 1, 2012 to assist individuals with TBI to reintegrate back into their communities

Click here to learn more and to access program forms.

Click here to make a referral.

MEDICAL Providers Online Prior Authorization Submission Implementation

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Fax number changes!!

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PAS Nursing Home

Please enter through the PARTICIPATING PROVIDERS portal at the left or click here.

Fax number changes!!

Note: The Bureau for Medical Services has requested that APS Healthcare remind referring providers that the University of Virginia Medical Center will discontinue as an active provider for WV Medicaid on 12/1/10.

Due to the University of Virginia Medical Center closing their relationship with West Virginia Medicaid, members will need to contact their primary care physician (PCP) or their referring physician when needing a referral to another provider/facility that is an active enrolled provider with West Virginia Medicaid Title XIX Program. 

If the physician requires assistance to determine enrolled West Virginia Medicaid providers, please refer to our Fiscal Agent, Molina Healthcare at wvmmis@molinahealthcare.com or telephone 1-888-483-0793 and listen to the options before proceeding.

The contact person at West Virginia Medicaid is Nora McQuain, RN, telephone number 304-558-5959.

Hours of Operation: Monday through Friday, 8 a.m. – 5 p.m.
(except for the following eight (8) holidays: New Year’s Day (January 1), President's Day (3rd Monday in February), Memorial Day (last Monday in May), Independence Day (July 4th), Labor Day (1st Monday in September), Thanksgiving Day (4th Thursday in November), Friday After Thanksgiving and Christmas Day (December 25th.) Any fixed holiday that falls on a Saturday will be observed the Friday before. Fixed holidays that fall on a Sunday will be observed the following Monday.)

© 2012 APS Healthcare