Legislative Update

Access to Health Care & Insurance

Bills Committee Last action Date
HB 1450 - Ware - Health insurer/health maintenance organization; response to notice from pharmacy's intermediary. (H) Committee on Commerce and Labor

(S) Committee on Commerce and Labor
(G) Acts of Assembly Chapter text (CHAP0615)03/16/17
notes: Requires a health insurer or health maintenance organization, or its intermediary (the carrier), when it receives notice from a pharmacy's intermediary of the pharmacy's agreement to accept reimbursement for its services at rates applicable to pharmacies that are preferred providers as payment in full, to respond to the notice in the same manner as it is currently required to respond to a notice received from the pharmacy. The measure does not require a carrier to contract with a pharmacy's intermediary and does not prohibit a carrier from contracting with a pharmacy's intermediary.
HB 1474 - Orrock - Dental hygienist; remote supervision. (H) Committee on Health, Welfare and Institutions

(S) Committee on Education and Health
(G) Acts of Assembly Chapter text (CHAP0410)03/13/17
notes: Eliminates the requirement that a dental hygienist providing dental hygiene services under remote supervision be employed by the supervising dentist; clarifies continuing education requirements for dental hygienists practicing under remote supervision; eliminates the requirement for written permission to treat a patient from a dentist who has treated the patient in the previous 12 months; and allows a dental hygienist practicing under remote supervision to treat a patient who provides verbal confirmation that he does not have a dentist of record whom he is seeing regularly. The bill eliminates the requirement that a dental hygienist practicing under remote supervision consult with the supervising dentist prior to providing further dental hygiene services if the patient is medically compromised or has periodontal disease and allows a dental hygienist practicing under remote supervision to provide further dental hygiene services in accordance with a written practice protocol developed and provided by the supervising dentist, which shall consider, at minimum, the medical complexity of the patient and the presenting signs and symptoms of oral disease. The bill requires a supervising dentist who conducts the examination of the patient or refers the patient to another dentist for examination following the 90-day period during which a dental hygienist is permitted to provide dental hygiene services under remote supervision to develop a diagnosis and treatment plan for the patient.
HB 1497 - Farrell - Ophthalmic prescriptions; definitions, who may provide prescriptions, requirements. (H) Committee on Health, Welfare and Institutions

(S) Committee on Education and Health
(G) Acts of Assembly Chapter text (CHAP0169)02/23/17
notes: Defines "eye examination" and "ophthalmic prescription" and sets out requirements for each. The bill prohibits the dispensing of eyeglasses or contact lenses unless the patient provides a valid ophthalmic prescription and prohibits ophthalmologists and optometrists from requiring patients to purchase ophthalmic goods, pay additional fees, or sign a waiver or release in exchange for a copy of an ophthalmic prescription. The bill provides that a violation of its requirements is a Class 2 misdemeanor.
HB 1544 - Collins - Certificates of public need; conditions on certificates, alternative plans of compliance. (H) Committee on Health, Welfare and Institutions

(S) Committee on Education and Health
(G) Acts of Assembly Chapter text (CHAP0768)03/27/17
notes: Provides that in cases in which a certificate holder holds more than one certificate of public need with conditions, and the certificate holder is unable to satisfy the conditions of one certificate, the Department of Health may provide for satisfaction of the conditions on that certificate by the provision of care at a reduced rate to indigent individuals in excess of the amount required by another certificate issued to the same holder, in an amount approved by the Department as part of an alternative plan of compliance.
HB 1549 - Farrell - Community services boards and behavioral health authorities; services to be provided, report. (H) Committee on Appropriations

(S) Committee on Finance
(G) Acts of Assembly Chapter text (CHAP0683)03/20/17
notes: Provides that the core of services provided by community services boards and behavioral health authorities shall include, effective July 1, 2018, (i) same-day access to mental health screening services and (ii) outpatient primary care screening and monitoring services for physical health indicators and health risks and follow-up services for individuals identified as being in need of assistance with overcoming barriers to accessing primary health services. The bill provides that the core of services provided by community services boards and behavioral health authorities shall additionally include, effective July 1, 2021, crisis services for individuals with mental health or substance use disorders; outpatient mental health and substance abuse services; psychiatric rehabilitation services; peer support and family support services; mental health services for certain members of the armed forces and veterans; care coordination services; and case management services, including targeted mental health case management services. The bill also requires the Department of Behavioral Health and Developmental Services to report annually regarding progress in the implementation of this act.
HB 1728 - Ransone - Air transportation services providers; VDH to review rules for use in medical situations. (H) Committee on Health, Welfare and Institutions

(S) Committee on Education and Health
(G) Acts of Assembly Chapter text (CHAP0172)02/23/17
notes: Directs the Department of Health to convene a work group to review the rules governing use of air transportation services, also known as air ambulances, in emergency medical situations and protocols for the dispatch of air transportation services in response to emergency medical situations and to provide recommendations for changes to such rules or protocols. The Department shall report its findings and recommendations to the Governor and the General Assembly by December 1, 2017.
HB 1748 - O'Bannon - Charity health care services; liability protection for administrators. (H) Committee for Courts of Justice

(S) Committee for Courts of Justice
(G) Acts of Assembly Chapter text (CHAP0415)03/13/17
notes: Adds to the list of persons who are exempt from liability resulting from the rendering of certain services persons who organize, arrange, promote, or administer health care services voluntarily and without compensation to any patient of any clinic that is organized in whole or in part for the delivery of health care services without charge or any clinic for the indigent and uninsured that is organized for the delivery of primary health care services as a federally qualified health center designated by the Centers for Medicare & Medicaid Services.
HB 2037 - Miller - Health insurance; calculation of cost-sharing provisions. (H) Committee on Commerce and Labor

(S) Committee on Commerce and Labor
(G) Acts of Assembly Chapter text (CHAP0588)03/16/17
notes: Provides that when there is no amount actually paid or payable by a health insurer, health services plan, or health maintenance organization to a provider for covered services, the insurer, health services plan, or health maintenance organization is required to calculate the cost-sharing obligation of the insured, subscriber, or enrollee based on a fee schedule.
HB 2053 - Landes - Direct primary care agreements; the Commonwealth's insurance laws do not apply. (H) Committee on Commerce and Labor

(S) Committee on Commerce and Labor
(G) Acts of Assembly Chapter text (CHAP0830)04/26/17
notes: Provides that the Commonwealth's insurance laws do not apply to direct primary care agreements. The measure further provides that (i) a direct primary care practice is not subject to the jurisdiction of the State Corporation Commission (SCC) and is not required to obtain a certificate of authority or license to market, sell, or offer to sell a direct primary care agreement; (ii) entering into a direct primary care agreement shall not be considered to be engaging in the business of insurance; and (iii) a direct primary care agreement is not a contract of insurance and is not subject to regulation by the SCC. The bill defines a direct primary care agreement as an agreement entered into between a health care provider and an individual patient under which the provider charges a predetermined fee as consideration for providing primary care to the patient, subject to certain conditions. A direct primary care practice is prohibited from submitting a claim to an insurer with respect to services provided to direct primary care patients covered by their direct primary care agreement, unless the services are outside the scope of the agreement. The measure provides that a willful or intentional violation constitutes an act of unprofessional conduct punishable by the Board of Medicine.
HB 2162 - Pillion - Substance-exposed infants; study of barriers to treatment in Commonwealth. (H) Committee on Health, Welfare and Institutions

(S) Committee on Rules
(G) Acts of Assembly Chapter text (CHAP0197)02/23/17
notes: Directs the Secretary of Health and Human Resources (the Secretary) to convene a work group to study barriers to treatment of substance-exposed infants in the Commonwealth. Such work group shall include representatives of the Departments of Behavioral Health and Developmental Services and Health and Social Services and such other stakeholders as the Secretary may deem appropriate and shall (i) review current policies and practices governing the identification and treatment of substance exposed infants in the Commonwealth; (ii) identify barriers to treatment of substance exposed infants in the Commonwealth, including barriers related to identification and reporting of such infants, data collection, interagency coordination and collaboration, service planning, service availability, and funding; and (iii) develop legislative, budgetary, and policy recommendations for the elimination of barriers to treatment of substance-exposed infants in the Commonwealth. The Secretary shall report his findings to the Governor and the General Assembly by December 1, 2017.
HB 2225 - Head - Hospital data reporting; charity care policies and other activities, clarifies definition. (H) Committee on Health, Welfare and Institutions

(S) Committee on Education and Health
(S) Incorporated by Education and Health (HB2101-Byron) (15-Y 0-N)02/16/17
notes: Defines "charity care" as care provided in accordance with a provider's policy of providing health care services free of charge or at a reduced rate because of the indigence or medical indigence of the patient. The bill requires all hospitals, doctors of medicine and osteopathy, and dentists licensed to practice as oral and maxillofacial surgeons to establish charity care policies and post information about such policies in a public place; requires health care providers to submit to the Commissioner of Health data on the amount of charity care provided; provides that the value of charity care shall be determined in accordance with fee schedules for Medicare services established by CMS; provides that in the case of a health care provider providing services at more than one facility, charity care shall be reported for each facility at which services are provided and shall not be aggregated by the provider; and requires not-for-profit hospitals to (i) conduct community needs assessments and develop strategies to meet the needs identified, (ii) establish financial assistance policies for patients, (iii) establish limits on charges for emergency and other medically necessary care for individuals eligible for assistance under the financial assistance policy, and (iv) ensure that the hospital does not engage in extraordinary actions to collect amounts owed before determining whether the person is eligible for financial assistance. The bill also requires not-for-profit hospitals to report annually to the Commissioner of Health on (a) the outcomes of the community needs assessment and the implementation of the strategy developed to meet the community health needs identified through such assessment; (b) the financial assistance
HB 2301 - O'Bannon - Nurses, licensed practical; administration of vaccinations. (H) Committee on Health, Welfare and Institutions

(S) Committee on Education and Health
(G) Acts of Assembly Chapter text (CHAP0182)02/23/17
notes: Removes the requirement that the supervision of licensed practical nurses administering vaccinations by registered nurses be immediate and direct.
SB 800 - Stanley - Direct primary care agreements; the Commonwealth's insurance laws do not apply. (H) Committee on Commerce and Labor

(S) Committee on Commerce and Labor
(G) Acts of Assembly Chapter text (CHAP0831)04/26/17
notes: Provides that the Commonwealth's insurance laws do not apply to direct primary care agreements. The measure further provides that (i) a direct primary care practice is not subject to the jurisdiction of the State Corporation Commission (SCC)and is not equired to obtain a certificate of authority or license to market, sell,or offer to sell a direct primary care agreement; (ii) entering into a direct primary care agreement shall not be considered to be engaging in the business of insurance; and (iii) a direct primary care agreement is not a contract of insurance and is not subject to regulation by the SCC. The bill defines a direct primary care agreement as an agreement entered into between a health care practice and a direct primary care patient under which the practice is authorized to charge a periodic fee as consideration for providing ongoing primary care to the patient, subject to certain conditions. A direct primary care practice is prohibited from submitting a claim to an insurer with respect to services provided to direct primary care patients covered by their direct primary care agreement, unless the services are outside of the patient's direct primary care agreement.
SB 981 - Stanley - Charity health care services; liability protection for administrators. (H) Committee for Courts of Justice

(S) Committee on Education and Health
(G) Acts of Assembly Chapter text (CHAP0057)02/20/17
notes: Provides that persons who administer, organize, arrange, or promote the rendering of services to patients of certain clinics shall not be liable for any civil damages for any act or omission resulting from the rendering of such services unless the act or omission was the result of such persons' or the clinic's gross negligence or willful misconduct.
SB 1009 - Dunnavant - Telemedicine, practice of; prescribing controlled substances. (H) Committee on Health, Welfare and Institutions

(S) Committee on Education and Health
(G) Acts of Assembly Chapter text (CHAP0058)02/20/17
notes: Provides that a health care practitioner who performs or has performed an appropriate examination of the patient, either physically or by the use of instrumentation and diagnostic equipment, for the purpose of establishing a bona fide practitioner-patient relationship may prescribe Schedule II through VI controlled substances to the patient, provided that the prescribing of such controlled substance is in compliance with federal requirements for the practice of telemedicine. The bill also authorizes the Board of Pharmacy to register an entity at which a patient is treated by the use of instrumentation and diagnostic equipment for the purpose of establishing a bona fide practitioner-patient relationship and is prescribed Schedule II through VI controlled substances to possess and administer Schedule II through VI controlled substances when such prescribing is in compliance with federal requirements for the practice of telemedicine and the patient is not in the physical presence of a practitioner registered with the U.S. Drug Enforcement Administration.
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