Health insurance; mandated benefits; treatment of menopause and perimenopause. Requires each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services to provide coverage for medically necessary treatment and care for menopause and perimenopause, as described in the bill.
Mental health and substance abuse disorders; network adequacy standards; comparative analyses; report; emergency regulations. Directs the Department of Health to issue regulations that include quantitative network adequacy standards for timely access to care, travel time, and geographical distance that are at least as stringent as those imposed for qualified health plans and qualified dental plans. The bill amends the definitions of "mental health services" and "substance abuse services" for the purposes of health insurance coverage.The bill requires health carriers to submit all comparative analyses prepared pursuant to federal law to the Bureau of Insurance on the date and frequency as specified by the Bureau and includes additional information to include in such submission. Under the bill, the Bureau may impose a penalty not to exceed $100,000 for a noncompliant or insufficient comparative analysis or require a carrier to remove, revise, or remedy noncompliant treatment limitations. The bill also amends the contents of the annual report submitted by the Bureau to the General Assembly to cover enforcement efforts with respect to the federal Mental Health Parity and Addiction Equity Act of 2008.The bill authorizes the Bureau to promulgate regulations as necessary to implement the provisions of the bill and directs the Department of Health to adopt emergency regulations to implement the provisions of the bill. The bill directs the Department of Human Resource Management to evaluate the impact of the proposed changes to the provisions of the bill related to health insurance. The provisions of the bill related to health insurance have a delayed effective date of July 1, 2027. This bill is identical to HB 656.
Department of Health; reduction of opioid overdose and opioid overdose deaths; report. Directs the Department of Health to develop a strategic plan for opioid overdose response to reduce rates of drug overdose and drug overdose deaths in the Commonwealth and to provide a report on the status of such strategic plan and its implementation to the Governor, the Chairs of the House Committees on Appropriations and Health and Human Services and the Senate Committees on Education and Health and Finance and Appropriations, and the Joint Commission on Health Care by November 1, 2026, and annually thereafter. As introduced, this bill was a recommendation of the Joint Commission on Health Care. This bill is identical to SB 308.
School nurses; sickle cell disease training. Directs local school divisions to require school nurses to complete, within six months of employment and at least every three years thereafter, an online or in-person course of instruction approved by the Board in collaboration with the Department of Health regarding recognition and management of sickle cell disease. This bill is identical to SB 822.
Department of Veterans Services; Department of Health Professions; military medical personnel; program; work group; report. Expands the definition of "military medical personnel" for the purposes of the program established by the Department of Veterans Services (the Department), in collaboration with the Department of Health Professions, that allows such military medical personnel to practice and perform certain delegated acts that constitute the practice of medicine or nursing to include other enlisted service members who have successfully completed appropriate technical training and any required certifications and who were discharged or released from such service under conditions other than dishonorable. Under current law, "military medical personnel" means an individual who has recently served as a medic in the United States Army, medical technician in the United States Air Force, medical personnel in the United States Space Force, or corpsman in the United States Navy or the United States Coast Guard.The bill allows such military medical personnel participating in the program to be supervised by any licensed practitioner, as defined in the bill. Current law allows such personnel to be supervised by a physician or podiatrist. The bill directs the Department of Veterans Services to convene a work group to provide guidance on the implementation and further development of the Military Medics and Corpsmen program and to report its findings to the Chairs of the House Committee on Health and Human Services and the Senate Committee on Education and Health by November 1, 2026.
Nonemergency medical transportation providers; fee disclosure. Requires a nonemergency medical transportation provider or the medical care facility prearranging transport through such a provider, prior to providing such transportation services to a patient, to provide the patient or the patient's representative with a standardized disclosure form of all associated fees or other charges for which the patient will be responsible for such transportation services. The bill also requires that nonemergency medical transportation providers provide the medical care facility with the required form. Such provisions have a delayed effective date of January 1, 2027. Finally, effective July 1, 2026, the bill directs the Department of Health to develop and publish a standardized disclosure form on its website by October 1, 2026.
Health insurance; claims experience information. Provides that provisions requiring insurers to provide policyholders with certain claims experience information apply to all employee welfare benefit plans and include pharmacy benefits claims.
Certificate of public need; expedited review of certain projects; duties of the State Health Services Plan Task Force. Directs the State Health Services Plan Task Force to develop recommendations for designating areas of the state with an identifiable need for additional projects, taking into account numerous barriers of access to health care. The bill also directs the Board of Health to promulgate updated regulations for expedited application and review processes for certain projects. This bill is identical to SB 239.
Prescription Drug Affordability Advisory Panel established; maximum fair price; annual reports; civil penalties. Directs the Secretary of Health and Human Resources to establish the Prescription Drug Affordability Advisory Panel to conduct data analyses, develop policy recommendations, and identify implementation barriers related to strategies to improve prescription drug affordability, enhance price transparency, and strengthen data collection practices for prescription drugs across public and private payers. The bill requires the Panel to (i) report annually on prescription drug pricing trends and any policy recommendations on legislation to improve prescription drug affordability and (ii) provide quarterly updates on prescription drug pricing trends. The bill requires each pharmacy benefits manager to provide to the Panel, upon request, certain information relating to the dispensation of a referenced drug, as defined in the bill.The bill prohibits prescription drug manufacturers or wholesale distributors permitted or licensed in the Commonwealth from accepting payment at an amount higher than the maximum fair price established by the U.S. Secretary of Health and Human Services pursuant to federal law for the sale of a referenced drug intended for use by individuals in the Commonwealth. Under the bill, an entity that violates such prohibition is subject to a civil penalty of $10,000 per violation. The bill also prohibits a manufacturer subject to its provisions from removing a referenced drug from sale distribution in the Commonwealth for the purpose of avoiding the impact of the bill's rate limitations without providing certain prior notice. Under the bill, a manufacturer that violates such prohibition on removing a referenced drug without the required notice is subject to a civil penalty equal to the greater of $100,000 or the total amount of annual savings for the referenced drug, as determined by the Board of Pharmacy. This bill is identical to HB 483.
Minor elementary or secondary school students admitted to inpatient treatment; certain disclosures to certain school personnel upon discharge. Provides that in the event that the facility to which a minor elementary or secondary school student is admitted to inpatient treatment determines that such minor student requires additional educational services upon discharge from the facility, the parents of such student may opt in to the disclosure, prior to or at the time of such minor student's discharge from the facility, of such determination by the facility to a mental health professional employed in such minor student's school or, if applicable, by the school division in which the student is enrolled. The bill also provides that, in the event that the facility to which a minor elementary or secondary school student is admitted to inpatient treatment determines, based on communications from such minor student to a mental health service provider at such facility, that the student poses a specific and immediate threat to cause serious bodily injury or death to an identified or readily identifiable person or persons at the time of the student's discharge from the facility, the facility shall disclose, prior to or at the time of discharge in accordance with the requirements set forth in relevant law, such determination to a mental health professional employed in such minor student's school or, if applicable, by the school division. The bill also prohibits any such facility from withholding discharge of such a student for the purpose of making any such disclosure. The provisions of the bill have a delayed effective date of January 1, 2027.
