Healthcare

Department of Medical Assistance Services; consultation with federally recognized tribes. Establishes a Tribal Medicaid Advisory Group to work collaboratively on (i) plan amendments, waiver requests, and policies affecting tribal health programs at least 60 days prior to submitting them for public notice and comment and (ii) a tribal health program billing manual. The advisory group is required to meet in person on at least a quarterly basis. The bill also requires the Department of Medical Assistance Services to (a) recognize the eligibility of any tribal health program to participate as a provider in the state plan, (b) consult with any tribal health program participating in the state plan at least 60 days prior to taking any adverse action, including suspension of payments or investigation regarding the participation of any tribal health program in the state plan, and (c) engage in ongoing consultation with federally recognized tribes and tribal health programs to address the needs of the state and tribal governments. This bill is a recommendation of the Commission on Updating Virginia Law to Reflect Federal Recognition of Virginia Tribes.

Weapons; possession prohibited in a hospital that provides mental health services or developmental services; penalty. Makes it a Class 1 misdemeanor for any person to knowingly and intentionally possess in the building of any hospital that provides mental health services or developmental services in the Commonwealth, including an emergency department or other facility rendering emergency medical care, a (i) firearm, (ii) knife with a blade over three and one-half inches, or (iii) other dangerous weapon, including explosives and stun weapons. The bill also provides that notice of such prohibitions shall be posted conspicuously at each public entrance of any hospital and that no person shall be convicted of the offense if such notice is not posted, unless such person had actual notice of the prohibitions. The bill provides that such firearm, knife, explosive, or weapon shall be subject to seizure by a law-enforcement officer and forfeited to the Commonwealth and specifies certain exceptions to the prohibition. This bill is identical to SB 173.

Board of Medicine; office-based buprenorphine treatment; counseling. Directs the Board of Medicine to amend its regulations regarding office-based buprenorphine treatment to require providers to offer counseling or referral to counseling to each patient as clinically necessary and mutually agreed-upon. The bill specifies that a patient's refusal of counseling does not preclude the patient from receiving office-based buprenorphine treatment for opioid use disorder. This bill is a recommendation of the Joint Commission on Health Care and is identical to SB 641.

Nursing facilities; related party rent disclosures; incentive payment reduction; penalty. Requires any nursing facility enrolled as a Medicaid provider that makes rent or lease payments to publicly disclose information related to the rent or lease payments, including whether payments are made to a related party, the nature of the related party, and the related party rent expense, as defined in the bill. The bill requires the Department of Medical Assistance Services to determine whether related party rent expenses exceed a fair rental value benchmark and if so, deduct a portion of any incentive payment owed to the nursing facility. A knowingly false attestation or disclosure is punishable as a Class 3 misdemeanor.

Health insurance; coverage for non-opioid prescription drugs. Prohibits a health insurance carrier from imposing any cost-sharing, prior authorization, step therapy, or other limitation on coverage of a covered non-opioid drug approved by the U.S. Food and Drug Administration for the treatment or management of pain that is more restrictive or less favorable to the enrollee relative to a covered opioid drug approved by the U.S. Food and Drug Administration for the treatment or management of pain.

Provision of abortion; informed written consent; newborn safety devices. Requires the physician or advanced practice registered nurse authorized to perform an abortion, induction, or termination to provide certain written information regarding newborn safety devices for the purposes of effectuating a pregnant woman's informed written consent prior to the abortion, induction, or termination. The bill directs the Department of Health to publish by October 1, 2026, in English and in each language that is the primary language of two percent or more of the population of the Commonwealth, such information relating to newborn safety devices in such a way as to ensure that the information is easily comprehensible.

Department of Medical Assistance Services; Medicaid waivers; consumer-directed services; employer of record. Directs the Department of Medical Assistance Services (DMAS) to modify the program rules for consumer-directed services available through certain Medicaid waivers to allow an individual receiving services to serve as the employer of record (EOR) for his own service delivery and designate another individual to perform all or a portion of the duties of the EOR on the individual's behalf when the individual receiving services is unable to perform such duties or direct his own care. The bill specifies that when an individual (i) has not yet reached the age of majority, (ii) is ineligible to use his existing employer identification number (EIN) to facilitate the taxation of benefits, or (iii) is otherwise determined to be ineligible by DMAS by administrative rule, the EIN shall be assigned to the individual receiving services and shall not be transferred to another individual. Under the bill, DMAS has the authority to limit such amendments to specify that an individual receiving services may make such designation no more than twice per calendar year.

Victims of crime; reimbursement for expenses; work group. Provides that all medical fees expended in the gathering of evidence through anonymous trace evidence collection kit examinations conducted on victims complaining of strangulation pursuant to relevant law shall be paid by the Commonwealth through the Criminal Injuries Compensation Fund (also known as the Virginia Victims Fund) administered by the Virginia Workers' Compensation Commission. The bill states that such victims shall not be required to participate in the criminal justice system or cooperate with law-enforcement authorities in order to be provided with such medical exams. Under current law, all medical fees expended in the gathering of evidence through physical evidence recovery kit examinations conducted on victims complaining of sexual assault are paid by the Commonwealth via the Fund, and victims complaining of sexual assault are not required to participate in the criminal justice system or cooperate with law-enforcement authorities in order to be provided with such forensic medical exams. The bill expands the powers and duties of the Commission to adopt, promulgate, amend, and rescind suitable rules and regulations to include a distinct policy for the payment of anonymous trace evidence collection kit examinations. Lastly, the bill directs the Director of the Department of Criminal Justice Services to convene a work group of relevant stakeholders to discuss and submit recommendations for certain matters related to the reimbursement process for forensic medical examinations, enumerated in the bill. The bill directs the work group to submit a report with recommendations to the Chairs of the House Committee on Health and Human Services, the House Committee on Appropriations, the Senate Committee on Education and Health, and the Senate Committee on Finance and Appropriations by November 1, 2026. This bill is identical to HB 1464.

Department of Medical Assistance Services; 1915(c) Home and Community Based Waivers; program rule amendments; direct support professionals. Directs the Department of Medical Assistance Services to seek the necessary approvals to amend the program rules for the Community Living and Family and Individual Supports Waivers to provide for compensation of a direct support professional for a waiver recipient in an acute care hospital under certain circumstances.

Virginia Opioid Use Reduction and Jail-Based Substance Use Disorder Treatment and Transition Fund; grant procedures. Requires the grant procedure to govern funds awarded to local and regional jails for the planning or operation of substance use disorder treatment services and transition services for persons with substance use disorder who are incarcerated in local and regional jails to include requirements that (i) any grant awarded shall be made for up to three years and (ii) an applicant for a grant submit a plan demonstrating how such applicant will become independently financially viable within the time period for which the grant is awarded. This bill is a recommendation of the Joint Commission on Health Care and is identical to SB 599.