Programs for at-risk students; permissible uses of funding. Includes as covered programs that are eligible for funding under the At-Risk Program initiatives to support both the physical and mental health of students in public schools, including the hiring of licensed practical nurses, registered nurses, and advanced practice registered nurses. This bill is a recommendation of the School Health Services Committee and is identical to SB 33.
Programs for at-risk students; permissible uses of funding. Includes as covered programs that are eligible for funding under the At-Risk Program initiatives to support both the physical and mental health of students in public schools, including the hiring of licensed practical nurses, registered nurses, and advanced practice registered nurses. This bill is a recommendation of the School Health Services Committee and is identical to HB 195.
Pharmacy benefits managers; requirements; scope; report. Requires all health insurance carriers to use the pass-through pricing model and may limit a pharmacy benefits manager from deriving income from pharmacy benefits management services provided to a carrier except for income derived from a pharmacy benefits management fee. The bill prohibits a pharmacy benefits manager from (i) reversing and or resubmitting the claim of a pharmacist or pharmacy without meeting certain requirements, (ii) reducing any payment to a pharmacist or pharmacy to an effective rate of reimbursement, or (iii) retroactively denying or reducing a claim or aggregate of claims except under certain circumstances. The bill requires the State Corporation Commission (the Commission) to examine the practice of carriers or pharmacy benefits managers requiring or inducing covered individuals to utilize pharmacy services at an affiliated pharmacy. The Commission is required to report its findings and recommendations to the General Assembly by December 1, 2027. Certain provisions of the bill have a delayed effective date of July 1, 2027. This bill incorporates SB 410 and SB 413 and is identical to HB 830.
Health insurance; tobacco surcharge. Eliminates the authority of a health carrier to vary its premium rates based on tobacco use. Under current law, a health carrier may charge premium rates up to 1.5 times higher for a tobacco user than for a nonuser. The provisions of the bill apply to health benefit plans providing individual or small group health insurance coverage entered into, amended, extended, or renewed on or after January 1, 2027.
Virginia Health Workforce Development Authority; administration of nursing scholarships. Grants the Virginia Health Workforce Development Authority the authority to administer scholarships related to nursing and to promulgate regulations exempt from the requirements of the Administrative Process Act as may be necessary to carry out the administration of nursing scholarship and loan programs. Under current law, the Board of Health is the administrative authority for such scholarships and the Commissioner of Health serves as the fiscal agent for the Board in the administration of some scholarship funds. The bill directs the Authority to establish an annual reporting schedule requiring submission of health workforce data, requires the Authority to establish and provide oversight and strategic guidance to the Virginia Nursing Workforce Center, and grants the Authority the authority to evaluate health workforce programs administered or supported by the Commonwealth. The bill directs the Virginia Nursing Workforce Center to establish an advisory board to provide it with strategic oversight and guidance. This bill is identical to HB 815.
Life insurance; health insurance; unfair discrimination; pre-exposure prophylaxis for prevention of human immunodeficiency virus. Prohibits any person from refusing to insure, refusing to continue to insure, or limiting the amount or extent of life insurance or accident and sickness insurance coverage available to an individual or charge an individual a different rate for the same coverage based solely on the status of such individual as having received pre-exposure prophylaxis for the prevention of human immunodeficiency virus.
Health care providers; required estimate for nonemergency health care services. Requires health care providers to provide a good faith estimate of the payment amount for which the patient will be responsible for such nonemergency health care service, including any fees or other charges for an item or service the patient may reasonably be expected to receive in connection with the nonemergency health care service. The bill requires the good faith estimate to include (i) description of the scheduled nonemergency health care service, (ii) the provider's standard charge for the service and any related item or service, (iii) the provider's standard charges and any contracted rates known at the time the estimate is prepared, and (iv) a statement that the estimate is not binding and the actual amount billed may differ depending on changes in the scope of services or the health carrier's processing of the claim.
Public institutions of higher education; financial assistance; Medical Education Service Grant Program established; report. Establishes the Medical Education Service Grant Program (the Program) for the purpose of providing grants to any person enrolled in or admitted to an eligible institution, as defined in the bill, that shall be awarded in whole or in part upon satisfactory completion of a service agreement entered into by a recipient to engage in clinical practice in a designated service area, as defined in the bill, for the requisite period and in accordance with the requirements set forth by the bill. The bill directs the State Council of Higher Education for Virginia (the Council), in partnership with the Virginia Health Workforce Development Authority (the Authority), to administer the Program. The bill also (i) establishes requirements for the administration of the Program, including (a) requirements for eligibility to apply to and receive a grant under the Program and the prioritization of Program applications and (b) terms and conditions governing the awarding of grants under the Program; (ii) directs the Council and the Authority to establish policies and procedures for the administration of the Program relating to monitoring and enforcing compliance of recipients with Program requirements and terms and conditions; and (iii) directs the program administrator to annually collect data on the activities of the Program for the preceding fiscal year and submit to the Governor and the Chairs of the House Committees on Education, Health and Human Services, and Appropriations and the Senate Committees on Education and Health and Finance and Appropriations a report on such data by January 1 of each year in which funds are made available for the Program.
Department of Medical Assistance Services; Department of Social Services; administration of medical assistance and social services programs; technology modernization; report. Directs the Department of Social Services (DSS) and the Department of Medical Assistance Services (DMAS) to contract with a third-party vendor to study and create a plan for the modernization of the technological systems used to administer federal benefit programs in the Commonwealth. The bill requires DSS and DMAS to develop and submit a legislative report that includes a plan to modernize the current technological systems to the Governor and the Chairs of the House Committee on Health and Human Services and the Senate Committee on Rehabilitation and Social Services by December 1, 2026, and to use the recommendations and plan outlined in such legislative report to move forward with the procurement process.
Newborn screening requirements; Gaucher disease. Directs the Department of Health to amend regulations to include Gaucher disease under the Commonwealth's newborn screening panel.
