Health insurance; carrier business practices; electronic attachments. Provides that, in the following contexts, information may be submitted by a provider to a health insurance carrier through electronic attachment, as defined in the bill: (i) information related to services rendered as required by the carrier in its provider contract; (ii) information related to any defect or impropriety that prevents the carrier from deeming a health insurance claim a clean claim, as defined in existing law; and (iii) information required to establish medical necessity, benefit coverage, or prior authorization of services, or to conduct reconsideration activities. The bill has a delayed effective date of January 1, 2027. This bill is identical to HB 676.
Health insurance; reporting requirements. Amends various reporting requirements related to health insurance, including by requiring the State Corporation Commission to maintain and publicly post an inventory of mandated benefits and providers, requiring health carriers to report annually on provider terminations and reinstatements, and consolidating reports related to balance billing and arbitration. The bill repeals reporting requirements related to the Comparable Health Care Service Incentive Program and Virginia Health Savings Account Plan.
Temporary detention; certified evaluators; sunset extended. Extends from July 1, 2026, to July 1, 2027, the sunset date on the current provisions of law authorizing hospitals with a psychiatric emergency department located in the City of Hampton to employ certain trained individuals to perform evaluations to determine whether a person meets the criteria for temporary detention for behavioral health treatment. The current law also requires participating hospitals with psychiatric emergency departments in the City of Hampton to submit monthly and annual reports on temporary detentions and crisis evaluations. This bill is identical to HB 1292.
Department of Medical Assistance Services; Autism Competencies Checklist; positive behavior support facilitators; training. Directs the Department of Medical Assistance Services to amend its regulations relating to the Autism Competencies Checklist to allow positive behavior support facilitators to conduct training sessions on such competencies for direct support professionals and direct support professional supervisors who provide support for individuals with developmental disabilities.
Temporary detention; certified evaluators; sunset extended. Extends from July 1, 2026, to July 1, 2027, the sunset date on the current provisions of law authorizing hospitals with a psychiatric emergency department located in the City of Hampton to employ certain trained individuals to perform evaluations to determine whether a person meets the criteria for temporary detention for behavioral health treatment. The current law also requires participating hospitals with psychiatric emergency departments in the City of Hampton to submit monthly and annual reports on temporary detentions and crisis evaluations. This bill is identical to SB 735.
Developmental disability waivers; financial eligibility standards; sunset repeal. Repeals the July 1, 2026, sunset on provisions directing the Department of Medical Assistance Services to disregard Social Security Disability Insurance income above the maximum monthly Supplemental Security Income when determining financial eligibility for developmental disability waivers.
Programs for at-risk students; permissible uses of funding. Includes as covered programs that are eligible for funding under the At-Risk Program initiatives to support both the physical and mental health of students in public schools, including the hiring of licensed practical nurses, registered nurses, and advanced practice registered nurses. This bill is a recommendation of the School Health Services Committee and is identical to HB 195.
Health insurance; tobacco surcharge. Eliminates the authority of a health carrier to vary its premium rates based on tobacco use. Under current law, a health carrier may charge premium rates up to 1.5 times higher for a tobacco user than for a nonuser. The provisions of the bill apply to health benefit plans providing individual or small group health insurance coverage entered into, amended, extended, or renewed on or after January 1, 2027.
Virginia Health Workforce Development Authority; administration of nursing scholarships. Grants the Virginia Health Workforce Development Authority the authority to administer scholarships related to nursing and to promulgate regulations exempt from the requirements of the Administrative Process Act as may be necessary to carry out the administration of nursing scholarship and loan programs. Under current law, the Board of Health is the administrative authority for such scholarships and the Commissioner of Health serves as the fiscal agent for the Board in the administration of some scholarship funds. The bill directs the Authority to establish an annual reporting schedule requiring submission of health workforce data, requires the Authority to establish and provide oversight and strategic guidance to the Virginia Nursing Workforce Center, and grants the Authority the authority to evaluate health workforce programs administered or supported by the Commonwealth. The bill directs the Virginia Nursing Workforce Center to establish an advisory board to provide it with strategic oversight and guidance. This bill is identical to HB 815.
Health insurance; tobacco surcharge. Eliminates the authority of a health carrier to vary its premium rates based on tobacco use. Under current law, a health carrier may charge premium rates up to 1.5 times higher for a tobacco user than for a nonuser. The provisions of the bill apply to health benefit plans providing individual or small group health insurance coverage entered into, amended, extended, or renewed on or after January 1, 2027. This bill is identical to HB 220.