Inspection of certified nursing facilities; compliance with federal reporting requirements; civil penalty. Directs the Department of Health to include validation of compliance with federal reporting requirements in its inspection process for certified nursing facilities. The bill requires certified nursing facilities to submit a quarterly report detailing (i) all self-reported incidents and compliance issues submitted to the Centers for Medicare and Medicaid Services during the preceding quarter; (ii) any corrective actions taken in response to self-reported incidents; and (iii) updates on ongoing investigations related to reported incidents. The Department may impose a penalty on a certified nursing facility that fails to comply with the reporting requirements imposed by the bill, which may include a civil penalty not to exceed $1,000, increased frequency of inspections, and suspension or revocation of the certified nursing facility's license.
Department of Medical Assistance Services; earned income disregard; cost-of-living adjustment. Directs the Department of Medical Assistance Services to seek the necessary federal approvals to increase, as necessary based upon Social Security Administration cost-of-living adjustments, the earned income disregard for workers with disabilities.
Independent Pharmacy Access and Resilience Pilot Program; report; sunset. Establishes the Independent Pharmacy Access and Resilience Pilot Program in the Department of Health to strengthen and stabilize access to pharmacy services in medically underserved communities and communities at heightened risk of pharmacy closure. The Program is established as a pilot program with an expiration date of July 1, 2030, and participation is limited to 12 independent pharmacies meeting certain criteria outlined in the bill. The bill directs the Department to submit to the Governor and General Assembly an interim report with evaluations of participating pharmacies no later than November 1, 2028, and a final comprehensive evaluation no later than November 1, 2029, in order for the General Assembly to determine whether to continue, modify, expand, or terminate the Program.
Department of Medical Assistance Services; 1915(c) Home and Community Based Waivers; program rule amendments; direct support professionals. Directs the Department of Medical Assistance Services to seek the necessary approvals to amend the program rules for the Community Living and Family and Individual Supports Waivers to provide for compensation of a direct support professional for a waiver recipient in an acute care hospital under certain circumstances.
Department of Health; Department of Social Services; publicly accessible nursing home information portal; publicly accessible assisted living facility information portal; reporting of incidents involving emergency medical services. Directs the Department of Health to establish a nursing home information portal and the Department of Social Services to establish an assisted living facility information portal to consolidate publicly available information on nursing homes and assisted living facilities, respectively. The bill requires operators of nursing homes and assisted living facilities to submit a quarterly report to the Department of Health or the Department of Social Services, respectively, with information on incidents involving emergency medical services.
Hospitals; itemized statements; non-emergent procedures, tests, or services. Requires hospitals to provide patients with an itemized statement of charges for services rendered for any non-emergent medical procedure, test, or service.
Department of Medical Assistance Services; Department of Social Services; Medicaid eligibility determination appeal time limit; mailed communications time period. Directs (i) the Department of Medical Assistance Services to amend its regulations to extend the time limit for appeals of eligibility determinations and (ii) the Department of Medical Assistance Services and the Department of Social Services to amend their regulations to create a mailing time period for communications related to Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and Temporary Assistance to Needy Families (TANF).
Department of Medical Assistance Services; sickle cell disease; feasibility of Medicaid benefit and Medicaid Health Homes; report. Directs the Department of Medical Assistance Services to determine the feasibility of participating in an optional Medicaid benefit for sickle cell disease and establishing Medicaid Health Homes to coordinate care and provide treatment for individuals with sickle cell disease. The bill requires the Department to report its findings in its annual review of sickle cell disease treatment and submit such review to the Chairmen of the House Committee on Health and Human Services and the Senate Committee on Education and Health and the Joint Commission on Health Care by November 15, 2026.
Department of Medical Assistance Services; Family Access to Medical Insurance Security Plan; literacy pilot program. Directs the Department of Medical Assistance Services to seek the necessary permissions from the Centers for Medicare and Medicaid Services to authorize and fund a pilot program promoting early literacy and parental bonding as part of routine pediatric primary care visits in select underserved localities through a partnership with Reach Out and Read.
Department of Medical Assistance Services; consultation with federally recognized tribes. Establishes a Tribal Medicaid Advisory Group to work collaboratively on (i) plan amendments, waiver requests, and policies affecting tribal health programs at least 60 days prior to submitting them for public notice and comment and (ii) a tribal health program billing manual. The advisory group is required to meet in person on at least a quarterly basis. The bill also requires the Department of Medical Assistance Services to (a) recognize the eligibility of any tribal health program to participate as a provider in the state plan, (b) consult with any tribal health program participating in the state plan at least 60 days prior to taking any adverse action, including suspension of payments or investigation regarding the participation of any tribal health program in the state plan, and (c) engage in ongoing consultation with federally recognized tribes and tribal health programs to address the needs of the state and tribal governments. This bill is a recommendation of the Commission on Updating Virginia Law to Reflect Federal Recognition of Virginia Tribes.
