It is possible to satisfy W. Va. Code § 30-3-15 and still be non-compliant, because the certificate of authorization is about the entity and the oversight obligation is about the care.
A physician medical director is expected to exercise genuine oversight of the medical services delivered. In a state that has taken the trouble to make the board see your corporate structure, a director-in-name-only arrangement is a poor bet.
What genuine oversight produces
- Written standing orders or protocols for every service on the menu, signed and dated.
- A good faith examination and treatment plan before treatment, by a qualified practitioner.
- Delegation only to practitioners whose licence and training support the task.
- Availability — a named physician reachable while patients are being treated.
- Documented review: charts, adverse events, protocol updates.
Why the paper trail matters more here
The certificate of authorization means the Board already has a file on your entity. If a complaint arrives, the Board is not starting from scratch; it is adding to a record it opened when you applied.
That argues for keeping oversight evidence contemporaneous rather than reconstructable. A protocol dated after the incident is worse than no protocol at all.
A practical test
Ask what would happen if your medical director were unavailable for two weeks. If the answer is “nothing changes, we keep treating”, the oversight is nominal. If the answer involves a named covering physician and a protocol for what pauses, the oversight is real.
That test is not West Virginia-specific, but a state that pre-registers your entity is a state where you want to be able to pass it.
Related reading
Frequently asked questions
Does West Virginia require a medical director?
A physician medical director with genuine oversight of the medical services delivered is expected.
Is that the same as the certificate of authorization?
No. The certificate authorizes the entity; oversight governs the care.
What evidences real oversight?
Signed protocols, good faith exams, documented delegation, availability, and contemporaneous chart and incident review.
What is the risk of a nominal director?
The Board already holds a file on your entity from the authorization process, so a nominal arrangement is unusually exposed.
General information about West Virginia requirements, not legal advice. Confirm your obligations with counsel licensed in West Virginia.