Health Care Learning Lab and Regulatory Improvement Program established. Requires the Department of Health (the Department) to establish the Health Care Learning Lab and Regulatory Improvement Program (the Program) to enable a person to obtain limited access to the market in the Commonwealth to temporarily test an innovative health care product or service on a limited basis without otherwise being licensed or authorized to act under the laws of the Commonwealth. Under the Program, an applicant requests the waiver of certain laws, regulations, or other requirements for a 24-month testing period, with an option to request an additional six-month testing period. The bill provides application requirements, consumer protections, procedures for exiting the Program or requesting an extension, and recordkeeping and reporting requirements. The bill requires the Department to provide an annual report to the Chairs of the House Committee on Health and Human Services and the Senate Committee on Education and Health that provides information regarding each Program participant and recommendations regarding the effectiveness of the Program. The bill directs the Board of Health to adopt emergency regulations to implement the provisions of the bill and has an expiration date of July 1, 2030.
Health insurance; coverage for doula care services. Requires health insurers, corporations providing health care subscription contracts, and health maintenance organizations whose policy, contract, or plan includes coverage for obstetrical services to provide coverage for doula care services provided by a state-certified doula. The bill requires such coverage to include coverage for at least eight visits during the antepartum or postpartum period and support during labor and delivery. The bill provides that health insurance carriers are (i) not required to pay for duplicate services actually rendered by both a state-certified doula and another health care provider and (ii) prohibited from requiring supervision, signature, or referral by any other health care provider as a condition of reimbursement for doula care services, except when those requirements are also applicable to other categories of health care providers.
Comprehensive children's health care coverage program. Directs the Department of Medical Assistance Services (the Department) to establish a program to provide state-funded comprehensive health care coverage for individuals in the Commonwealth who are (i) under 19 years of age and (ii) not covered under a group health plan or health insurance coverage, or otherwise eligible for medical assistance services through the Commonwealth's program of medical assistance services established pursuant to Title XIX or XXI of the Social Security Act. The bill also requires the Department to ensure that all program information is made available in a manner that is accessible to individuals with limited English proficiency and individuals with disabilities through the provision of language access services, including oral interpretation and written translation, free of charge and to ensure that information obtained by the program remains confidential and is not disclosed for any purpose not related to the administration of the program or any purpose related to civil immigration enforcement unless the subject of the information consents to such disclosure or the requesting agency presents a valid judicial order, subpoena, or warrant. The bill requires the Department to seek all federal waivers and other approvals necessary to maximize federal financial participation in the cost of carrying out the program established by the bill.
Palliative Care Information and Education Program; Palliative Care and Quality of Life Advisory Council established. Directs the Board of Health to include in its regulations a requirement that every hospital, nursing home, and certified nursing facility licensed by the Board (i) establish a system for identifying patients or residents who may benefit from palliative care and (ii) provide information about and facilitate access to appropriate palliative care services for patients or residents experiencing illness, injuries, or conditions that substantially affect quality of life for more than a short period of time. The bill also directs the Department of Health to establish a palliative care consumer and professional information and education program to maximize the effectiveness of palliative care initiatives in the Commonwealth by (a) ensuring that comprehensive and accurate information and education about palliative care is available to the public, health care providers, and health care facilities and (b) implementing such other initiatives related to education about palliative care and the delivery of palliative care services as may be necessary to educate health care professionals and the public about palliative care. The bill further establishes the Palliative Care and Quality of Life Advisory Council to advise the Department on matters related to the establishment, operation, maintenance, and outcomes evaluations of such initiatives. The bill directs the Palliative Care and Quality of Life Advisory Council to study the possibility of establishing a Medicaid benefit for palliative care and the need for a licensure scheme for palliative care providers. The bill further directs the Board of Health to develop a statewide advanced care planning campaign to increase public awareness of available palliative care options.
Inspection of certified nursing facilities; compliance with federal reporting requirements; civil penalty. Directs the Department of Health to include validation of compliance with federal reporting requirements in its inspection process for certified nursing facilities. The bill requires certified nursing facilities to submit a quarterly report detailing (i) all self-reported incidents and compliance issues submitted to the Centers for Medicare and Medicaid Services during the preceding quarter; (ii) any corrective actions taken in response to self-reported incidents; and (iii) updates on ongoing investigations related to reported incidents. The Department may impose a penalty on a certified nursing facility that fails to comply with the reporting requirements imposed by the bill, which may include a civil penalty not to exceed $1,000, increased frequency of inspections, and suspension or revocation of the certified nursing facility's license.
Department of Medical Assistance Services; earned income disregard; cost-of-living adjustment. Directs the Department of Medical Assistance Services to seek the necessary federal approvals to increase, as necessary based upon Social Security Administration cost-of-living adjustments, the earned income disregard for workers with disabilities.
Independent Pharmacy Access and Resilience Pilot Program; report; sunset. Establishes the Independent Pharmacy Access and Resilience Pilot Program in the Department of Health to strengthen and stabilize access to pharmacy services in medically underserved communities and communities at heightened risk of pharmacy closure. The Program is established as a pilot program with an expiration date of July 1, 2030, and participation is limited to 12 independent pharmacies meeting certain criteria outlined in the bill. The bill directs the Department to submit to the Governor and General Assembly an interim report with evaluations of participating pharmacies no later than November 1, 2028, and a final comprehensive evaluation no later than November 1, 2029, in order for the General Assembly to determine whether to continue, modify, expand, or terminate the Program.
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.
Health insurance; coverage for the treatment of acquired brain injury required. Requires health insurance carriers to provide coverage for the treatment of acquired brain injury that includes coverage for treatment using cognitive rehabilitation therapy, cognitive communication therapy, neurocognitive therapy, neuropsychological testing, neurofeedback therapy, functional rehabilitation therapy, community reintegration services, post-acute residential treatment services, inpatient services, outpatient and day treatment services, and home and community-based treatment.
Department of Health; Department of Social Services; publicly accessible nursing home information portal; publicly accessible assisted living facility information portal; reporting of incidents involving emergency medical services. Directs the Department of Health to establish a nursing home information portal and the Department of Social Services to establish an assisted living facility information portal to consolidate publicly available information on nursing homes and assisted living facilities, respectively. The bill requires operators of nursing homes and assisted living facilities to submit a quarterly report to the Department of Health or the Department of Social Services, respectively, with information on incidents involving emergency medical services.
