Healthcare

Health insurance; pharmacies; freedom of choice; delivery of prescription drugs; penalties. Prohibits an insurer, health maintenance organization, corporation providing preferred provider subscription contracts, or pharmacy benefits manager from imposing upon any person receiving pharmaceutical benefits any policy or practice requiring or incentivizing certain provisions relating to the delivery of prescription drugs. A violation of the bill's provisions constitutes an unfair trade practice under existing law and is subject to injunctive, penalty, and enforcement provisions in existing law.

Bureau of Insurance; evaluation of All-Payer Claims Database; report. Directs the State Corporation Commission's Bureau of Insurance (the Bureau) to conduct an evaluation of the All-Payer Claims Database and the data submitted thereto in facilitating data-driven, evidence-based improvements in access, quality, and cost of health care in the Commonwealth. The bill requires the Bureau to submit a report of its findings and recommendations to the Governor and General Assembly no later than December 1, 2026.

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.

Medical assistance services; volunteer emergency medical services agencies; supplemental payment for ground emergency medical services vehicle transportation. Directs the State Board of Health to include a provision in the state plan for medical assistance services to implement a supplemental payment program for qualified volunteer emergency medical services agencies to cover the difference between the agency's costs for ground emergency medical services vehicle transport services and the reimbursement amount received from the Department of Medical Assistance Services.

Medical malpractice information disclosures; report. Requires insurers who issue medical malpractice liability insurance polices covering health care providers in the Commonwealth to disclose, for the preceding calendar year, information regarding (i) premiums; (ii) claims activity; (iii) claim payments and litigation costs; and (iv) insurer financial condition. The bill further requires every hospital or health system licensed in the Commonwealth that maintains self-insurance, captive insurance, risk retention arrangements, or other retained financial risk for medical malpractice liability to disclose information regarding (a) the numbers of physicians and health care providers covered under the malpractice liability program; (b) claims activity; (c) malpractice expenditures; and (d) the total malpractice liability expenditures for the reporting year. The bill further requires such insurers, hospitals, and health care systems to provide a list of verdicts during the reporting year in medical malpractice actions in which the jury verdict exceeded the medical malpractice limitation on recovery. The bill provides that such disclosures and information be submitted to the Chairs of the House and Senate Committees for Courts of Justice and to the ranking Delegate and Senator of the minority party serving on such Committees on or before September 1, 2026, for the 2025 calendar year and on or before March 31 of each year thereafter for the preceding calendar year.

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).

Medical cannabis; administration to terminally ill patients; report. Directs the Department of Health to promulgate regulations specifying that hospital staff may store, dispense, and administer cannabis oil when a patient has valid certification and exempts such staff from criminal penalties for possession of cannabis oil. The bill directs the Department of Health to convene a work group to discuss the implementation process for providing cannabis products to patients in medical care facilities and report on its discussion to the Chairs of the House Committee on Health and Human Services and the Senate Committee on Education and Health by November 1, 2026. This bill is identical to HB 75.

Pharmacists; initiation of treatment; influenza prophylaxis. Permits pharmacists to initiate treatment with, dispense, or administer drugs and devices for prophylactic purposes to prevent or mitigate the symptoms of influenza virus infection.

Health records; disclosure of laboratory test results; waiting period. Requires health care entities to wait 72 hours before disclosing test results that could indicate malignancy or genetic markers as part of a patient's health records unless the disclosure of such test results is requested by the patient, is not possible due to the health care entity's electronic health records system, or such early disclosure is in the patient's best interest. The bill permits health care entities to disclose health records to an electronic health information exchange to comply with the federal 21st Century Cures Act.

Comprehensive children's health care coverage program. Directs the Department of Medical Assistance Services (the Department) to establish a program to provide state-funded comprehensive health care coverage for individuals in the Commonwealth who are (i) under 19 years of age and (ii) not covered under a group health plan or health insurance coverage, or otherwise eligible for medical assistance services through the Commonwealth's program of medical assistance services established pursuant to Title XIX or XXI of the Social Security Act. The bill also requires the Department to ensure that all program information is made available in a manner that is accessible to individuals with limited English proficiency and individuals with disabilities through the provision of language access services, including oral interpretation and written translation, free of charge and to ensure that information obtained by the program remains confidential and is not disclosed for any purpose not related to the administration of the program or any purpose related to civil immigration enforcement unless the subject of the information consents to such disclosure or the requesting agency presents a valid judicial order, subpoena, or warrant. The bill requires the Department to seek all federal waivers and other approvals necessary to maximize federal financial participation in the cost of carrying out the program established by the bill.