Public elementary and secondary schools; student diabetes medical care and management. Establishes several provisions relating to student diabetes medical care and management in public elementary and secondary schools in the Commonwealth, including requiring divisionwide plans for the care of students who are diagnosed with diabetes in each school division, effective beginning with the 2028–2029 school year. This bill is identical to HB 1301.
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.
Access to investigational drugs, biological products, and devices; patient with severely debilitating condition. Allows a patient who has a severely debilitating condition, defined in the bill as a disease or condition that causes major irreversible morbidity, to access investigational drugs, biological products, and devices when certain criteria are met. Under current law, only a patient who has a terminal condition may access such drugs, products, and devices.
Department of Behavioral Health and Developmental Services; individuals receiving services; right to send and receive mail. Allows state facilities operated by the Department of Behavioral Health and Developmental Services to process sealed letter mail for electronic delivery. This bill is identical to HB 1304.
Health Insurance Premium Stabilization Tax Credit Act. Establishes the Health Insurance Premium Stabilization Tax Credit Act, through which a qualified taxpayer, defined in the bill, shall be allowed a refundable income tax credit for taxable years 2026 through 2030 in an amount equal to such taxpayer's certifiable premium. The bill provides that the Health Benefit Exchange Division of the State Corporation Commission shall determine each qualifying taxpayer's certifiable premium for each taxable year in which such taxpayer may claim a health insurance premium stabilization tax credit and shall annually report such amount to the Department of Taxation. Such amount, with respect to any taxable year, shall be the sum of each coverage month's premium balance across all coverage months for such taxable year, as described in the bill.
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 SB 161.
Health Coordination Network Program; patient data collection. Renames the Smartchart Network Program as the Health Coordination Network Program and relocates it within the Code. The bill expands patient level data elements and requires the Commissioner of Health to enter into contract with an authorized nonprofit organization to create, operate, maintain, and administer the Health Coordination Network Program.
Commissioner of Health; feasibility of a statewide maternal health safety initiative; work group; reports. Directs the Commissioner of Health to convene a work group of relevant stakeholders, described in the bill, to evaluate the feasibility of a statewide maternal health safety initiative. The bill directs the Commissioner to submit an interim report of the work group by November 1, 2026, and a final report with the work group's recommendations no later than July 1, 2027, to the House Committee on Health and Human Services, the Senate Committee on Education and Health, and the Commission on Women's Health.
Department of Medical Assistance Services; community health workers in Medicaid managed care; report. Directs the Department of Medical Assistance Services (DMAS) to evaluate and develop recommendations for a statewide strategy to integrate community health workers into Medicaid managed care and related health and human services programs. The bill instructs DMAS to consult with the Department of Health, the Department of Social Services, the Department of Behavioral Health and Developmental Services, the Department for Aging and Rehabilitative Services, the Virginia Community Health Worker Association, Medicaid managed care organizations, local departments of social services, community-based providers, and other relevant stakeholders. The bill requires DMAS 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 the Senate Committee on Finance and Appropriations by December 1, 2026.
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 HB 424.
