Workers' compensation; employer's offset in event of recovery. Amends provisions related to an employer's offset for recovery in certain actions brought under the Virginia Workers' Compensation Act. The bill requires that lifetime medical award benefits and ongoing indemnity award benefits shall remain in full force and effect if the claimant is under such an award at the time that recovery is effected, subject to the employer offset provisions. Under the bill, an employer's credit shall be applied as a continuing, pro rata reduction to benefits otherwise payable under an existing award until the employer's required credit is exhausted. The bill also removes language limiting an employee's entitlement to compensation and expenses for medical, surgical, and hospital attention and funeral expenses.
Medical cannabis program; product labels; delivery. Changes the requirements for what is included on medical cannabis product labels affixed by pharmaceutical processors to include (i) the total milligrams of tetrahydrocannabinol (THC) and cannabidiol (CBD) included in the edible cannabis product or topical cannabis product, both defined in the bill; (ii) the number of milligrams of THC and CBD in each serving of the edible cannabis product or topical cannabis product; and (iii) the total percentage of THC and CBD included in the inhalable cannabis product, defined in the bill. Under current law, the product label of any medical cannabis product is required to include the total percentage and milligrams of THC and CBD included in the product and the number of milligrams of THC and CBD in each serving.The bill also allows a pharmaceutical processor or cannabis dispensing facility to dispense or deliver cannabis products in person to a patient or such patient's registered agent, parent, or legal guardian at any residence, including a temporary residence or business. However, the bill prohibits dispensing or delivering cannabis products to (a) any military base, child day center, school, or correctional facility; (b) the State Capitol; or (c) any public gathering places, including sporting events, festivals, fairs, races, concerts, and terminals of public transportation companies. The bill also specifies that all transportation or delivery of usable cannabis, botanical cannabis, cannabis oil, or cannabis products, whether by an employee or delivery agent, shall comply with all relevant laws and regulations and provides that the Board of Directors of the Virginia Cannabis Control Authority may suspend or revoke the privileges of any employee or delivery agent to transport or deliver such products for failure to comply. The bill also provides that the 12-month stability testing period for medical cannabis products begins on the date the cannabis product is tested, rather than the date of product registration approval and that any medical cannabis product with an expiration date exceeding 12 months shall be supported by stability testing measured from the testing date, rather than the date of product registration approval. The bill contains technical amendments.
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 is identical to SB 669.
Health insurance; cost-sharing payments for insulin and diabetes equipment and supplies; limit. Decreases the cap on the cost-sharing payment that a covered person is required to pay for a covered prescription insulin drug from $50 to $35 for a 30-day supply of the prescription insulin drug and provides such cap is an aggregate cap that applies in situations where the covered person is prescribed more than one insulin drug. The bill also establishes such an aggregate cap of $35 for a 30-day supply of diabetes equipment and supplies.
Licensed substance abuse treatment practitioners; licensure by endorsement; licensure without examination. Directs the Board of Counseling to establish a pathway to licensure by endorsement as a licensed substance abuse treatment practitioner for applicants who have held certification as a certified substance abuse counselor for at least 10 years without a history of disciplinary action, have completed at least five years of documented supervised experience, hold at least a master's degree in an appropriate field of counseling, and hold a Master Addiction Counselor credential issued by NAADAC, the Association for Addiction Professionals. The bill provides that such pathway to licensure by endorsement does not require examination.
Commissioner of Health; feasibility of a statewide maternal health safety initiative; work group; reports. Directs the Commissioner of Health to convene a work group of relevant stakeholders, described in the bill, to evaluate the feasibility of a statewide maternal health safety initiative. The bill directs the Commissioner to submit an interim report of the work group by November 1, 2026, and a final report with the work group's recommendations no later than July 1, 2027, to the House Committee on Health and Human Services, the Senate Committee on Education and Health, and the Commission on Women's Health.
Health insurance; ethics and fairness in carrier business practices; downcoded claims. Prohibits a carrier, intermediary, administrator, or representative of a carrier from downcoding a claim unless the decision to downcode is determined by a person or electronic system that reflects correct coding standards and considers all relevant patient data from the billing provider in making the determination. The bill requires a carrier, intermediary, administrator, or representative that downcodes a claim to provide certain notice to the provider. The bill requires that all downcoding dispute decisions are reviewed and adjudicated by a natural person.
Drug manufacturers; 340B Drug Pricing Program; work group; report. Directs the Secretary of Health and Human Resources to convene a work group to conduct a comprehensive evaluation of the impacts of the federal 340B Drug Pricing Program within the Commonwealth, with emphasis on governance, transparency, and the availability of pharmacy services in rural and underserved areas. The bill requires the work group to submit a report on its findings and recommendations to the Chairs of the Senate Committees on Finance and Appropriations and Education and Health and the House Committees on Appropriations and Health and Human Services by November 1, 2026.
Department of Health; reduction of opioid overdose and opioid overdose deaths; report. Directs the Department of Health to develop a strategic plan for opioid overdose response to reduce rates of drug overdose and drug overdose deaths in the Commonwealth and to provide a report on the status of such strategic plan and its implementation to the Governor, the Chairs of the House Committees on Appropriations and Health and Human Services and the Senate Committees on Education and Health and Finance and Appropriations, and the Joint Commission on Health Care by November 1, 2026, and annually thereafter. As introduced, this bill was a recommendation of the Joint Commission on Health Care. This bill is identical to HB 794.
Active Pharmaceutical Ingredient Manufacturing Grant Fund. Establishes the Active Pharmaceutical Ingredient Manufacturing Grant Fund to provide grant installment awards between July 1, 2026, and July 1, 2045, in an amount not to exceed $15 million per fiscal year and in an aggregate amount not to exceed $130 million, to a qualified company that (i) engages in the manufacture of pharmaceutical substances, (ii) executes a memorandum of understanding with the Commonwealth, and (iii) is expected to make a capital investment of at least $2,148,793,019 and create and maintain at least 468 new full-time jobs. This bill is identical to HB 800.
