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


Downloads

Download Files for the Financial Disclosure Policy Statement 2000-1 (Effective: Beginning with the fiscal year 2000 reporting period) - to be used by all "covered facilities" and related organizations in complying with financial disclosure requirements.
Statement of charges, fees, and salaries for goods and services rendered in excess of $55,000.00
Statement of charges, fees, and other sums collected in excess of $55,000.00
 55 Form Policy- Financial Disclosure Policy Statement 2000-1
 55 Electronic - Policy Attachment
 Form A (Excel Format) - Charges, Fees, and Salaries > $55,000.00 Paid to Employees
 Form B (Excel Format) - Charges, Fees, and Salaries > $55,000.00 Paid for Executive or Management Services
 Form C (Excel Format) - Charges, Fees, and Salaries > $55,000.00 Paid to Other Vendors
 Form D (Excel Format) - Charges, fees, and Other Sums > $55,000.00 Collected
 
Downloadable Files for the Hospital Uniform Reporting System (Uniform Report) to be used by hospitals in complying with financial disclosure requirements.
 Memorandum of Changes in 2011 Template
 Uniform Report Instructions Updated instructions to be posted soon.
 Uniform Report template revised 12/01/11
Uniform Financial Report Cross-walk 12/01/11

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