Emergency custody orders; transportation to treatment center or to residence of the person subject to emergency custody order. Provides that transportation provided pursuant to an emergency custody order shall include, upon completion of emergency medical evaluation or treatment, transportation to an approved treatment center or to the residence of the person subject to the emergency custody order.
Emergency protective orders; statement of alleged act of abuse. Requires that any emergency protective order issued in a general district court, juvenile and domestic relations district court, or circuit court include a statement of the grounds for requesting such order and that such statement be signed and sworn by either the law-enforcement officer or allegedly abused person who requested the order. The bill requires that such statement be included in or attached to the order when the order is served upon the respondent and with the original copy filed with the clerk.
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.
Health insurance; prior authorization requests reviewed by physician. Requires a provider contract between a health insurance carrier and a provider to contain provisions requiring (i) any decision to deny a prior authorization request for drug benefits or health care services is made by a licensed physician who is (a) an expert in the treatment of the enrollee's medical condition that is the subject of the prior authorization request and (b) knowledgeable about the recommended health care service or treatment through recent or current actual clinical experience treating patients with the same or similar medical condition of the enrollee and (ii) if the carrier is questioning the medical necessity of the request, the carrier will provide the enrollee's physician an opportunity to discuss the medical necessity of the health care service with the physician who will be responsible for determining authorization of the health care service or drug benefit under review.
Financial institutions; loans and legal rate of interest. Provides that for the purposes of provisions governing usury and the legal rate of interest, "making," when used in reference to a loan, means advancing, offering to advance, or making a commitment to advance funds to a borrower for a loan. The bill provides that the prohibition against a contract for the payment of interest on a loan at a rate that exceeds 12 percent per year applies to any person who seeks to evade its application by any device, subterfuge, or pretense whatsoever, including (i) making loans disguised as personal property sale and leaseback transactions; (ii) disguising loan proceeds as a cash rebate for the pretextual installment sale of goods or services; and (iii) making, offering, assisting, or arranging a debtor to obtain a loan with a greater rate of interest, consideration, or charge than permitted through any method, including mail, telephone, internet, or any electronic means, regardless of whether the person has a physical location in the Commonwealth.
Financial institutions; loans and legal rate of interest. Provides that for the purposes of provisions governing usury and the legal rate of interest, "making," when used in reference to a loan, means advancing, offering to advance, or making a commitment to advance funds to a borrower for a loan. The bill provides that the prohibition against a contract for the payment of interest on a loan at a rate that exceeds 12 percent per year applies to any person who seeks to evade its application by any device, subterfuge, or pretense whatsoever, including (i) making loans disguised as personal property sale and leaseback transactions; (ii) disguising loan proceeds as a cash rebate for the pretextual installment sale of goods or services; and (iii) making, offering, assisting, or arranging a debtor to obtain a loan with a greater rate of interest, consideration, or charge than permitted through any method, including mail, telephone, internet, or any electronic means, regardless of whether the person has a physical location in the Commonwealth.
Carrying assault firearms in public areas prohibited; penalty. Prohibits the carrying of certain semi-automatic center-fire rifles, pistols, and shotguns or any firearm modified to be operable as an assault firearm on any public street, road, alley, sidewalk, or public right-of-way or in any public park or any other place of whatever nature that is open to the public, with certain exceptions. Under current law, the prohibition on carrying certain shotguns and semi-automatic center-fire rifles and pistols applies to a narrower range of firearms, only in certain localities, and only when such firearms are loaded. A violation of this prohibition is a Class 1 misdemeanor. This bill was incorporated into SB 727.
Health insurance; prior authorization for health care services. Decreases from 72 hours to 24 hours and from seven days to five days the time by which a health insurance carrier is required to respond to expedited and standard requests for prior authorization for health care services, respectively. The bill prohibits a carrier from (i) denying a claim for the provision of dental services by a dentist or oral surgeon for failure to obtain prior authorization if the dentist or oral surgeon calls the dental plan during business hours to obtain such prior authorization and is unable to reach the dental plan or is placed on hold for longer than 15 minutes and (ii) downcoding a claim if a prior authorization was approved. The bill requires carriers to establish a system in which providers with high prior authorization approval rates are not required to obtain prior authorization for routine health care services. Additionally, the bill provides that if a prior authorization request is denied, the carrier is required to notify providers and enrollees if artificial-intelligence based tools were used in reviewing the request.
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.
Pharmacy benefits managers; various requirements; report. Prohibits a pharmacy benefits manager from (i) reimbursing a pharmacy in an amount less than the national average drug acquisition cost for the prescription drug or pharmacy service at the time the drug is administered or dispensed, plus a professional dispensing fee; (ii) basing pharmacy reimbursement for prescription drugs on patient outcomes, scores, or metrics; (iii) imposing a point-of-sale or retroactive fee on a pharmacy, pharmacist, or covered individual; (iv) receiving deductibles or copayments; (v) redirecting any prescription drug claims submitted by a pharmacy to any third-party discount card program, cash discount program, or any other non-insurance adjudication platform; (vi) using policy agreements incorporation into a pharmacy agreement, to materially change, alter, or modify the pharmacy agreement, reimbursement rates, payment terms, or other financial obligations; (vii) prohibiting a pharmacy from providing an individual certain information; (viii) charging a pharmacy a fee related to participation in a pharmacy network; (ix) requiring multiple specialty pharmacy accreditations as a prerequisite for participation in a pharmacy network that dispenses specialty drugs; or (x) deriving any revenue from a pharmacist, pharmacy, or covered individual in connection with performing pharmacy benefits management services. The bill requires a pharmacy benefits manager to calculate a covered individual's out-of-pocket cost for a covered prescription drug based on the net price of the prescription drug after taking into account all retained rebates associated with the prescription drug. The bill adds certain information to be included in a report that pharmacy benefit managers are currently required to submit and requires such report to be filed quarterly rather than annually. The bill also requires the Commissioner of Insurance to annually prepare and submit a report to the Governor and the General Assembly based on the information submitted by pharmacy benefits managers. Additionally, the bill prohibits a carrier or its pharmacy benefits manager from imposing any payment or condition relating to the purchase of pharmaceutical benefits from any pharmacy that is more costly or more restrictive than that which would be imposed upon such person if the same pharmaceutical services were purchased from a mail order pharmacy provider.
Emergency protective orders; duration. Extends the duration of an emergency protective order from a maximum of three days to a maximum of two weeks. The bill permits a petitioner, prior to the expiration of an emergency protective order, to file a written motion requesting to extend such order and authorizes a court, upon good cause shown, to extend the emergency protective order for an additional period of time not to exceed two weeks after expiration of the original order. Finally, the bill permits a court to continue an emergency protective order to the first hearing date of any related criminal offense. The bill contains technical amendments.
Elections; absentee voting in person; uniform availability. Requires absentee voting in person to be available between the hours of 8:00 a.m. and 5:00 p.m. Monday through Friday during early voting, between the hours of 8:00 a.m. and 5:00 p.m. on the first and second Saturday immediately preceding all elections, and between the hours of 1:00 p.m. and 5:00 p.m. on the second Sunday immediately preceding all elections. Under current law, local electoral boards have some discretion to decide certain hours and days when absentee voting in person is available.
