Healthcare

Department of Medical Assistance Services; state plan for medical assistance services; doula care. Adds provisions related to the provision of doula care under the state plan for medical assistance services specifying that such care includes support during labor and delivery and up to two linkage-to-care incentive payments for doulas.

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 HB 1337.

Victims of crime; reimbursement for expenses; work group. Provides that all medical fees expended in the gathering of evidence through anonymous trace evidence collection kit examinations conducted on victims complaining of strangulation pursuant to relevant law shall be paid by the Commonwealth through the Criminal Injuries Compensation Fund (also known as the Virginia Victims Fund) administered by the Virginia Workers' Compensation Commission. The bill states that such victims shall not be required to participate in the criminal justice system or cooperate with law-enforcement authorities in order to be provided with such medical exams. Under current law, all medical fees expended in the gathering of evidence through physical evidence recovery kit examinations conducted on victims complaining of sexual assault are paid by the Commonwealth via the Fund, and victims complaining of sexual assault are not required to participate in the criminal justice system or cooperate with law-enforcement authorities in order to be provided with such forensic medical exams. The bill expands the powers and duties of the Commission to adopt, promulgate, amend, and rescind suitable rules and regulations to include a distinct policy for the payment of anonymous trace evidence collection kit examinations. Lastly, the bill directs the Director of the Department of Criminal Justice Services to convene a work group of relevant stakeholders to discuss and submit recommendations for certain matters related to the reimbursement process for forensic medical examinations, enumerated in the bill. The bill directs the work group to submit a report with recommendations to the Chairs of the House Committee on Health and Human Services, the House Committee on Appropriations, the Senate Committee on Education and Health, and the Senate Committee on Finance and Appropriations by November 1, 2026. This bill is identical to HB 1464.

SB 822 requires school nurses in public schools to complete training on sickle cell disease. This directly affects school nurses and aims to better support students with sickle cell disease or those at risk. The key provision mandates this training to help nurses recognize symptoms and manage care during health crises. The bill's abstract focuses solely on implementing this training requirement for school health staff.

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.

Board of Behavioral Health and Developmental Services; regulations; service providers; emergency medical simulations; cardiopulmonary resuscitation. Directs the Board of Behavioral Health and Developmental Services to adopt regulations requiring certain providers to (i) conduct regular emergency medical simulations and train employees that regularly engage with people receiving services to prepare such employees to recognize and respond to situations where individuals receiving services require emergency medical treatment and (ii) require at least one employee trained in cardiopulmonary resuscitation to be on duty at each location where services are delivered.

Health insurance; limit on cost-sharing payments for prescription drugs under certain plans. Requires each carrier that offers a health plan in either the individual or small group market to ensure that at least one health plan in each of the bronze, silver, gold, and platinum levels of coverage in each rating area in the individual and small group market conform with the following: (i) a plan that offers a platinum level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $150 per 30-day supply of the prescription drug; (ii) a plan that offers a gold level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $200 per 30-day supply of the prescription drug; (iii) a plan that offers a silver level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $250 per 30-day supply of the prescription drug; and (iv) a plan that offers a bronze level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $300 per 30-day supply of the prescription drug. The bill requires that any plans offered to meet its requirements are (a) clearly and appropriately named to aid the consumer or plan sponsor in the plan selection process and (b) marketed in the same manner as other plans offered by the carrier. The bill's provisions apply to any individual or group accident and sickness insurance policy, any individual or group accident and sickness subscription contract, and any health care plan for health care services delivered, issued for delivery, or renewed in the Commonwealth on or after January 1, 2028. This bill is identical to HB 625.

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.

Health insurance; coverage for maternal mental health screenings. Requires health insurance carriers to provide coverage for maternal mental health screenings. The bill requires such coverage to include at least one maternal mental health screening to be conducted during pregnancy, at least one additional screening to be conducted during the first six weeks of the postpartum period, and additional medically necessary postpartum screenings. Additionally, the bill provides that coverage for a prescription drug for the treatment of a maternal mental health condition shall not be subject to prior authorization requirements unless there are clinically significant safety or efficacy concerns.