Healthcare

Health insurance; coverage for contraceptive drugs and devices. Requires health insurance carriers to provide coverage, under any health insurance contract, policy, or plan that includes coverage for prescription drugs on an outpatient basis, for contraceptive drugs and contraceptive devices approved by the U.S. Food and Drug Administration, including those available over-the-counter. The bill prohibits a health insurance carrier from imposing upon any person receiving prescription contraceptive benefits pursuant to the provisions of the bill any copayment, coinsurance payment, or fee, except in certain circumstances. Additionally, the bill requires any health benefit plan that provides coverage for hormonal contraceptives to provide point-of-sale coverage without cost-sharing at in-network pharmacies for hormonal contraceptives available over-the-counter. This bill is identical to HB 1182.

Health insurance; prohibited restrictions on in-network referrals. Prohibits a health insurance carrier from prohibiting an in-network provider, as defined in the bill, from referring any enrollee or specimen to any in-network clinical laboratory or in-network pathology service provider under the terms of such insurance unless such referral would constitute a violation of certain laws. This bill is identical to SB 745.

Comprehensive plan; social determinants of health. Encourages localities to utilize relevant and available data and research related to social determinants of health to consider how the locality's adopted comprehensive plan will impact the locality's overall public health and access to health care services.

Service member community members; medical care facilities; health care equity. Permits medical care facilities to screen each patient for information on their eligibility as a service member community member, as defined by the bill. The bill permits medical care facilities to identify service member community members as a vulnerable population and comply with the most recent health care equity standards published by The Joint Commission.

Child abuse or neglect; prenatal use of a controlled substance or drug as prescribed. Clarifies that a pregnant woman's prenatal use of a controlled substance or drug as prescribed by such woman's health care provider for opioid addiction recovery shall not solely be a reason to suspect that a child is abused or neglected.

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; Department of Corrections; peer recovery specialists. Directs the Virginia Department of Health and the Virginia Department of Corrections to develop agency guidelines for hiring peer recovery specialists with previous criminal convictions for compensated employment. As introduced, this bill was a recommendation of the Joint Commission on Health Care. This bill is identical to SB 608.

Pharmaceutical Substance Manufacturing Grant Fund. Establishes the Pharmaceutical Substance Manufacturing Grant Fund to provide grant installment awards between July 1, 2026, and July 1, 2045, in an amount not to exceed $34 million per fiscal year and in an aggregate amount not to exceed $191,255,000, to a qualified company that (i) engages in the manufacture of pharmaceutical substances, (ii) executes a memorandum of understanding with the Commonwealth, and (iii) is expected to make a capital investment of at least $4 billion and create and maintain at least 500 new full-time jobs. This bill is identical to HB 1076.

School boards; courses of instruction; high school courses or dual enrollment programs for certification as a certified nurse aide, emergency medical technician, or firefighter; establishment permitted; requirements. Permits any school board to provide to high school students, either on school premises or through a dual enrollment program or other partnership with a comprehensive community college, courses of instruction that prepare students for and lead to (i) certification as a certified nurse aide, provided that such course is approved by and meets the requirements of the Board of Nursing and is taught by a qualified individual, consistent with the requirements of the Board of Nursing; (ii) certification as an emergency medical technician, provided that such course is consistent with the requirements established by the Office of Emergency Medical Services and taught by an emergency medical technician instructor who meets the requirements set forth in the bill; or (iii) firefighting level 1 certification, as defined by the bill, provided that such course is consistent with the National Fire Protection Association 1001, level one, firefighter standards as administered by the Department of Fire Programs and taught by an individual qualified to provided such instruction. The bill also requires any school board that provides any such course of instruction on school premises to high school students to ensure that any individual employed, contracted, or permitted to volunteer to provide instruction in such course meets the requirements set forth in applicable law relating to data on convictions for certain crimes and child abuse and neglect, fingerprinting, and criminal history records checks.

Health insurance; coverage for early refills of prescription eye drops. Prohibits a health carrier from denying coverage to a covered person of an early refill of prescription eye drops if (i) the prescription eye drops are a covered benefit, (ii) the amount of time that has elapsed from the previous dispensing of such prescription would result in at least 85 percent of such prescription eye drops being used if taken consistently with the prescriber's directions, and (iii) the prescriber has indicated that additional quantities are medically necessary and the refill requested does not exceed such additional quantity. The provisions of the bill are applicable to contracts, policies, or plans delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2027.