Healthcare

Health insurance; notice of adverse determination. Requires health carriers to send in writing to a covered person the notice of an adverse determination or final adverse determination and the covered person's right to request an external review, as required by current law, within five business days after the adverse determination or final adverse determination has been made. The bill also requires such notice to include certain information related to the person who made the adverse determination or final adverse determination.

Physician assistants; authorization to practice without a practice agreement. Authorizes a physician assistant with at least three years of full-time clinical experience to practice without a practice agreement upon receipt of an attestation from a patient care team physician or patient care team podiatrist who provided collaboration and consultation to such physician assistant verifying the length and nature of the physician assistant's practice. The bill establishes methods for a physician assistant who is unable to obtain the required attestation to submit other evidence that the physician assistant meets the requirements to practice without a practice agreement and establishes a method for physician assistants who obtain licensure by endorsement to practice without a practice agreement if they meet the applicable requirements. The bill also establishes a scope of practice for physician assistants who practice without a practice agreement. The bill specifies that the effective date of the foregoing provisions are contingent upon the Board of Medicine adopting regulations to implement the bill's provisions and to establish processes for granting authorization to physician assistants to practice without a practice agreement.

Health insurance; requirements for certain opioid antagonists. Requires each health insurer, corporation providing health care subscription plans, and health maintenance organization whose policy, contract, or plan includes coverage for prescription drugs to include coverage for at least one opioid antagonist used for overdose reversal dispensed pursuant to an oral, written, or standing order of a prescriber and ensure that cost-sharing for at least one opioid antagonist used for overdose reversal is included on the lowest cost tier of the insurer's, corporation's, or health maintenance organization's prescription drug formulary. The bill provides that such coverage shall be exempt from any prior authorization or step therapy requirement on coverage of benefits. As introduced, this bill was a recommendation of the Joint Commission on Health Care. This bill is identical to HB 795.

Health insurance; requirements for certain opioid antagonists. Requires each health insurer, corporation providing health care subscription plans, and health maintenance organization whose policy, contract, or plan includes coverage for prescription drugs to include coverage for at least one other opioid antagonist used for overdose reversal dispensed pursuant to an oral, written, or standing order of a prescriber and ensure that cost-sharing for at least one opioid antagonist used for overdose reversal is included on the lowest cost tier of the insurer's, corporation's, or health maintenance organization's prescription drug formulary. The bill provides that such coverage shall be exempt from any prior authorization or step therapy requirement on coverage of benefits. As introduced, this bill was a recommendation of the Joint Commission on Health Care. This bill is identical to SB 257.

Competency treatment in misdemeanor proceedings. Provides that in cases where the defendant has been charged with a misdemeanor offense, the court may (i) order inpatient or outpatient treatment or (ii) dismiss the charges. Where a defendant is found to be incompetent, the bill permits a court to (a) order that such defendant receive treatment to restore his competency on an outpatient basis in a local correctional facility or at a location determined by the appropriate community services board or behavioral health authority, (b) order that such defendant receive treatment to restore his competency on an inpatient basis at a hospital designated by the Commissioner of Behavioral Health and Developmental Services as appropriate for treatment of persons under criminal charge, (c) order that such defendant be evaluated to determine whether he meets the criteria for temporary detention, or (d) dismiss the misdemeanor charge and release such defendant. The bill has a delayed effective date of July 1, 2027.

Suicide Prevention Program Coordinator; deaths by suicide of veterans or military service members; State Registrar of Vital Records; Department of Veterans Services annual report. Adds to the duties of the Suicide Prevention Coordinator within the Department of Veterans Services the duty to (i) compile and analyze data relating to the suicides of veterans and military service members pursuant to death certificates filed with the State Registrar of Vital Records, with such data to be included in the Department's annual report, and (ii) collaborate with the Department of Behavioral Health and Developmental Services to develop programs and resources related to suicide prevention for veterans and military service members. The bill provides that in any case where the death certificate of a veteran or military service member lists suicide as the manner of death, the State Registrar of Vital Records shall provide such information concerning the suicide to the Department.

Board of Medicine and Board of Nursing; continuing education; bias reduction training. Directs the Board of Medicine and Board of Nursing to require certain licensees to complete continuing learning activities on bias reduction in health care as part of their continuing education and continuing competency requirements for licensure and authorizes the Board of Nursing to require certain continuing learning activities or courses in a specific subject area. Under current law, the Board of Medicine has such authority. This bill is identical to SB 22.

Department of Medical Assistance Services; remote monitoring services through pregnancy and postpartum for high-risk pregnant patients; reimbursement. Expands provision for payment of medical assistance for remote patient monitoring services provided via telemedicine to include high-risk pregnant persons through 12 months postpartum. The bill directs the Department of Medical Assistance Services to assess expanding similar provision of payment for patients with advanced maternal age and submit a report of its findings to the General Assembly no later than November 1, 2026.

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 SB 405.

Nursing homes and certified nursing facilities; required liability insurance coverage. Provides that the regulations of the Board of Health shall require purchasers of licensed nursing homes or certified nursing facilities with claims-made policies of liability insurance coverage to purchase an extended reporting endorsement of two years after the date of sale or to purchase liability insurance coverage with dates that begin two years prior to the date the existing owner's policies end.