West Virginia Health Care Authority

100 Dee Drive
Charleston WV 25311
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Monday-Friday
8:30am-5:00pm

Phone 304-558-7000
Toll-Free 1-888-558-7002
Fax 304-558-7001


Disclosure Requirements

Facilities required to file financial disclosure documents with this agency pursuant to W. Va. Code § 16-29B-24 and the Financial Disclosure Rule, 65 C.S.R. § 13, must submit the following documents within 120 days of the end of the facility’s fiscal year, with the exception of a hospital’s uniform financial report, which is due 150 days after the end of the fiscal year.

​The following is the list of required financial disclosure items per facility type:
Hospital – Audited Financial Report, Statement of Charges for all services rendered, Uniform Financial Report, and the current Uniform Bill form in effect for inpatients.
Behavioral Health Facility – Audited Financial Report and Gross Rates for its top thirty services by utilization.
Kidney Disease Treatment Center (including a free-standing hemodialysis unit) – Audited Financial Report and Statement of Charges for all services rendered.
Ambulatory Health Care Facility – Audited Financial Report and Statement of Charges for all services rendered.
Ambulatory Surgical Facility – Audited Financial Report and Statement of Charges for all services rendered.
Home Health Agency – Audited Financial Report, Statement of Charges for all services rendered and an annual utilization survey.
Rehabilitation Facility – Audited Financial Report and Statement of Charges for all services rendered.
Community Mental Health or Intellectual Disability Facility – Audited Financial Report and Statement of Charges for all services rendered.
Community-Based Primary Care Centers – Audited Financial Report

If an audited financial report is not prepared by a covered facility, the facility shall provide the West Virginia Health Care Authority a statement of income (revenues and expenses), a statement of changes in retained earnings (fund balances), a statement of cash flows, a balance sheet for the reporting period and/or any other statement as required by generally accepted accounting principles. Multi-state facilities must provide statements reflecting their West Virginia operations.

Under certain circumstances, a consolidated format is acceptable for the audited statements; but if a covered facility is included in the consolidation, separate statements specific to the covered facility must be submitted. These may be unaudited.

A statement of charges for all services rendered is a schedule of current rates for all patient services. A behavioral health facility is only required to submit its gross rates for its top thirty services by utilization. Hospitals must submit a charge master electronically (CD/email) in Excel format. Other covered facilities may also submit an electronic file, but paper copies of current rates are acceptable.

Hospitals must submit a Uniform Financial Report electronically along with a pdf or paper copy of the signed certification page.

The Authority will conduct the annual utilization survey for home health providers. As a result, home health providers do not need to provide anything with regard to this requirement until the survey is received from the Authority.

Hospitals will continue to submit Uniform Bill (UB) data for each and every inpatient including Medicaid and Medicare patients. This must be submitted on a monthly basis in the format designated by the Authority.

All financial disclosure documents should be emailed to jfulks@hcawv.org or mailed to the attention of:

West Virginia Health Care Authority
Financial Analysis Division
100 Dee Drive
Charleston, West Virginia 25311

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