Healthcare

Maternal Health Monitoring Pilot Program established; report. Directs the Department of Health to implement the Maternal Health Monitoring Pilot Program that provides for remote patient monitoring for maternal hypertension and maternal diabetes. The bill requires the Department to select a managed care organization and technology vendor to administer the Pilot Program and to submit a report to the Governor and General Assembly no later than 18 months after the first eligible participant is enrolled in the Pilot Program.

Breakthrough Therapies for Veteran Suicide Prevention Act; fund and council established; report. Establishes the Breakthrough Therapies for Veteran Suicide Prevention Fund (the Fund) to provide funding to support clinical research and implementation of FDA Breakthrough Therapies, defined in the bill, for the treatment of post-traumatic stress disorder, treatment-resistant depression, major depressive disorder, and traumatic brain injury. Under the bill, the Fund shall be used to (i) establish public-private partnerships to jointly fund Phase III clinical trials of FDA Breakthrough Therapies; (ii) conduct investigator-initiated clinical trials; (iii) establish a compassionate use program; (iv) create education and training opportunities for mental health professionals; (v) begin patient access pilot programs; and (vi) conduct implementation studies for best practices, cost-effectiveness, and methods to reduce treatment costs. The bill also establishes the Breakthrough Therapies for Veteran Suicide Prevention Advisory Council to advise the Department of Health on administration of grant funding or contracting to carry out the purposes of the Fund. Finally, the bill requires the Board of Pharmacy to amend its regulations to designate, reschedule, or deschedule a controlled substance in accordance with federal law after the expiration of 30 days from the publication in the Federal Register of a final or interim final order or rule.

A BILL to amend the Code of Virginia by adding a section numbered 54.1-2971.2, relating to physicians; informed consent; disclosure of certain information prior to hysterectomy or oophorectomy.

Department of Medical Assistance Services; community health worker expansion. Directs the Department of Medical Assistance Services, in coordination with the Department of Health, Department of Social Services, Department of Behavioral Health and Developmental Services, and Department for Aging and Rehabilitative Services, to (i) evaluate opportunities for Medicaid managed care organizations to embed certified community health workers into care coordination models, (ii) evaluate the implementation of 2024 Medicare Community Health Integration services codes, (iii) develop and implement statewide workforce pathways for community health worker training, and (iv) identify opportunities to expand the use of community health workers in programs supporting high-cost Medicaid populations. The bill directs the Department of Medical Assistance Services to submit a report of its findings and recommendations to the Joint Commission on Health Care and the Chairs of the House Committee on Appropriations and Senate Committee on Finance and Appropriations no later than December 1, 2026.

Department of Behavioral Health and Developmental Services; Early Intervention Program for Infants and Toddlers with Disabilities; program extension. Directs the Department of Behavioral Health and Developmental Services to take all steps necessary to implement the federal extension option for the federal Early Intervention Program for Infants and Toddlers with Disabilities to allow children five years of age or younger to receive services through such program.

Virginia National Guard TRICARE Reimbursement Fund established. Establishes the Virginia National Guard TRICARE Reimbursement Fund for the purpose of reimbursing the costs of federal TRICARE dental insurance plan premiums and TRICARE Reserve Select health insurance plan premiums for Virginia National Guard members deemed eligible by the Adjutant General.

Ivermectin; over-the-counter sale. Authorizes the over-the-counter sale of ivermectin suitable for human use to persons 18 years of age or older without a prescription or consultation with a pharmacist or other health care professional.

State pharmacy benefits manager; contractual provisions; report. Requires the Department of Medical Assistance Services' contract with the state pharmacy benefits manager to (i) require that that ingredient-cost reimbursement is based on the national average drug acquisition cost, or if unavailable, the wholesale acquisition cost minus a discount set by the Department, plus a professional dispensing fee, determined by the Department; (ii) require real-time or near real-time transparency in drug costs, rebates collected and paid, dispensing fees paid, administrative fees, and all other charges, fees, costs, and holdbacks, claim denials appeals, and network participation; (iii) prohibit the state pharmacy benefits manager from steering Medicaid recipients to affiliated pharmacies through differential cost-sharing, restrictive network design, or the mandatory use of a mail order pharmacy provider; (iv) require the state pharmacy benefits manager to (a) meet network adequacy standards established by the Department; (b) allow any willing pharmacy to participate in the pharmacy network; (c) verify that all contracted pharmacies are actively accepting Medicaid recipients; (d) submit annual reports containing certain information; (e) disclose to the Department pricing and maximum acquisition cost methodologies; and (f) allow invoice-based or national average drug acquisition cost-based appeals and require an adjustment of rates network-wide when an appeal is upheld; and (v) include enforcement mechanisms and monetary penalties for noncompliance. Additionally, the bill requires Department to annually calculate the savings generated by the use of the state pharmacy benefits manager and to annually increase its dispensing fee by the amount of such savings. The bill requires the Department to annually (1) publish and make available on its website its annual and total savings achieved, the annual and total amount applied to dispensing fees increases, and the updated dispensing fees and (2) report to the General Assembly on the state pharmacy benefits manager's compliance, national average drug acquisition cost compliance, pharmacy reimbursement trends, network adequacy compliance, and dispensing fee sufficiency.

Constitutional amendment (voter referendum); fundamental right to reproductive freedom. Provides for a referendum at the November 3, 2026, election to approve or reject an amendment to the Constitution of Virginia relating to the right to make one's own decisions related to reproductive health care, including access to abortion. The amendment protects patients and their doctors and nurses from being punished for making such decisions. The amendment allows the state to place restrictions on access to abortion during the third trimester of pregnancy except when the patient's life or physical or mental health is at risk or the pregnancy cannot survive. This bill is identical to SB 449.

Virginia Fire Personnel and Equipment Grant Program established; report. Establishes the Virginia Fire Personnel and Equipment Grant Program (the Program) for the purpose of awarding grants to localities to hire additional firefighters and to improve their firefighting and emergency medical services. The bill specifies that the Department of Fire Programs (the Department) shall administer the Program and two types of grants shall be made from the Program. The first shall provide grants to localities to increase the number of firefighters. Such grants shall be made for up to three years and shall be used by localities for programs to (i) hire new, additional full-time firefighters; (ii) convert part-time or volunteer firefighters to full-time firefighters; or (iii) recruit and retain volunteer firefighters. The second shall award grants to localities for improving firefighting and emergency medical services, including by acquiring firefighting and emergency medical services vehicles and equipment and modifying facilities. For both grants, the bill provides that funds shall not be used to supplant any funds currently provided by the Commonwealth or by the locality and shall be used to increase the total amount of funds available for the provision of firefighting or emergency medical services. The bill requires the Department to submit a report annually, beginning November 1, 2027, to the Governor and the General Assembly containing a list of grants, the amount of each approved grant, information on the performance assessment system that the bill directs the Department to create, an evaluation of each grant based on such system, and any other criteria deemed relevant by the Department.