Healthcare

Health insurance; reporting requirements. Amends various reporting requirements related to health insurance, including by requiring the State Corporation Commission to maintain and publicly post an inventory of mandated benefits and providers, requiring health carriers to report annually on provider terminations and reinstatements, and consolidating reports related to balance billing and arbitration. The bill repeals reporting requirements related to the Comparable Health Care Service Incentive Program and Virginia Health Savings Account Plan.

Nonemergency medical transportation providers; fee disclosure. Requires a nonemergency medical transportation provider or the medical care facility prearranging transport through such a provider, prior to providing such transportation services to a patient, to provide the patient or the patient's representative with a standardized disclosure form of all associated fees or other charges for which the patient will be responsible for such transportation services. The bill also requires that nonemergency medical transportation providers provide the medical care facility with the required form. Such provisions have a delayed effective date of January 1, 2027. Finally, effective July 1, 2026, the bill directs the Department of Health to develop and publish a standardized disclosure form on its website by October 1, 2026.

Medical care facilities; expanded access to medical cannabis for terminally ill patients. Requires medical care facilities to permit terminally ill patients, as defined in the bill, to use medical cannabis. The bill requires medical care facilities to adopt policies facilitating the use of medical cannabis. The provisions of the bill do not apply to the provision of emergency medical services, including in emergency departments of hospitals. The bill requires compliance with applicable drug and medication requirements, specifies that compliance with its provisions shall not be a condition of obtaining, retaining, or renewing a license as a medical care facility, and establishes a protocol for noncompliance in the event of intervention by the federal government. The bill has a delayed effective date contingent on the federal rescheduling of marijuana from a Schedule I to a Schedule III drug. This bill was incorporated into HB 75.

Reports of fetal death; miscarriage; personally identifiable information not required. Provides that any fetal death report relating to a miscarriage shall not include a patient's name or any other personally identifiable information. The bill further directs the Department of Health to update its regulations in accordance with the provisions of the bill.

Health insurance; reporting requirements. Amends various reporting requirements related to health insurance, including by requiring the State Corporation Commission to maintain and publicly post an inventory of mandated benefits and providers, requiring health carriers to report annually on provider terminations and reinstatements, and consolidating reports related to balance billing and arbitration. The bill repeals reporting requirements related to the Comparable Health Care Service Incentive Program and Virginia Health Savings Account Plan.

Medical malpractice; limitation on recovery; certain actions. Eliminates the cap on the recovery in actions against health care providers for medical malpractice where the act or acts of malpractice occurred on or after July 1, 2026, and occurred against a patient age 10 or younger.

Virginia National Guard TRICARE Reimbursement Fund established. Establishes the Virginia National Guard TRICARE Reimbursement Fund for the purpose of reimbursing the costs of federal TRICARE dental insurance plan premiums and TRICARE Reserve Select health insurance plan premiums for Virginia National Guard members deemed eligible by the Adjutant General.

Line of Duty Act; transitional coverage. Requires the Department of Human Resource Management to acquire and provide temporary transitional health insurance coverage to disabled persons, eligible spouses, and eligible dependents during the period of transition into the LODA (Line of Duty Act) Health Benefits Plans. Current law authorizes but does not require the Department to acquire and provide such temporary transitional health insurance coverage to disabled persons, eligible spouses, and eligible dependents during such period.

Health insurance; ensuring fairness in cost-sharing; pharmacy benefits managers; compensation and duties: civil penalty. Amends provisions related to rebates provided by carriers and health benefit plans to health plan enrollees by defining "defined cost-sharing," "pharmacy benefits management services," and "price protection rebates." The bill requires that an enrollee's defined cost-sharing for each prescription drug be calculated at the point of sale based on a price that is reduced by an amount equal to at least 80 percent of all rebates received or expected to be received in connection with the dispensing or administration of the prescription drug. The bill prohibits a pharmacy benefits manager from deriving income from pharmacy benefits management services provided to a carrier or health benefit plan except for income derived from a pharmacy benefits management fee. The bill requires the amount of any pharmacy benefits management fees to be set forth in the agreement between the pharmacy benefits manager and the carrier or health benefit plan and that such fee not be based on the acquisition cost or any other price metric of a drug; the amount of savings, rebates, or other fees charged, realized, or collected by or generated based on the activity of the pharmacy benefits manager; or the amount of premiums, deductibles, or other cost-sharing or fees charged, realized, or collected by the pharmacy benefits manager from enrollees or other persons on behalf of an enrollee. The bill requires a pharmacy benefits manager to annually certify to the State Corporation Commission that it has met certain requirements. The Commission is directed to impose a civil penalty not to exceed $1,000 per claim for a violation of these provisions. The bill establishes a pharmacy benefits manager duty, which includes the duties of care, good faith, and fair dealing, owed to any enrollee, provider, or health benefit plan that receives pharmacy benefits management services from the pharmacy benefits manager or that furnishes, covers, receives, or is administered a unit of a prescription drug for which the pharmacy benefits manager has provided pharmacy benefits management services. The bill requires the Commission to define by regulation the scope of such duty and provides for a private cause of action for any person aggrieved by the breach of such duty.

Virginia Birth-Related Neurological Injury Compensation Program; electronic filing; review of claims. Requires electronic filing of claims under the Virginia Birth-Related Neurological Injury Compensation Program. The bill requires such claims to include an uncondensed and uncompressed fetal heart rate monitoring record and prenatal records and increases from 10 days to 21 days the timeframe in which the Program is required to file a response to a claim. The bill also increases from $3,000 to $6,000 the amount paid to the medical school that assesses and prepares a report for a claim.