Healthcare

Child abuse or neglect; prenatal use of a controlled substance or drug as prescribed. Clarifies that a pregnant woman's prenatal use of a controlled substance or drug as prescribed by such woman's health care provider for opioid addiction recovery shall not solely be a reason to suspect that a child is abused or neglected.

Secretary of Public Safety; firearm violence. Directs the Secretary of Public Safety to convene a work group to develop policy and legislative recommendations to establish the Virginia Gun Violence Prevention Center. The bill allows the work group to (i) meet both in-person and virtually, (ii) have small group breakouts for the purpose of advancing work in a timely and efficient manner, and (iii) collaborate with experts and other representatives as needed. The bill requires the work group to report its findings and any legislative and policy recommendations to the General Assembly by December 15, 2026. This bill is identical to SB 364.

Virginia Birth-Related Neurological Injury Compensation Program and Fund; board of directors; plan of operation; filing of claims; awards and coverage for expenses or services. Makes various changes to the Virginia Birth-Related Neurological Injury Compensation Program and Fund. The bill provides that a civil action arising out of or related to a birth-related neurological injury against a participating hospital or physician shall be referred to the Virginia Workers' Compensation Commission. Under the bill, the costs of the Virginia Workers' Compensation Commission maintaining an electronic filing system for the submission of petitions shall be reimbursed from the Fund. Under the bill, the Auditor of Public Accounts shall receive and review any audit conducted on the accounts of the Fund. The bill includes compensation for services provided by an education advocate. The bill requires the Program's board of directors to include a relative of a current or former beneficiary, allows for the electronic submission of claims, and expands discovery of parties to a claim. The bill further requires the Program's board of directors to establish a blanket surety bonding program for all employees with access to the Fund and requires the board to meet at least once monthly. Finally, the bill increases from $100,000 to $500,000 the amount that may be awarded to families whose infant has sustained a birth-related neurological injury. This bill is identical to SB 398.

Sickle Cell Trait Awareness and Education Program established. Directs the Department of Health to establish the Sickle Cell Trait Awareness and Education Program to raise public awareness of and provide education on sickle cell trait.

Bureau of Insurance; evaluation of All-Payer Claims Database; report. Directs the State Corporation Commission's Bureau of Insurance (the Bureau) to conduct an evaluation of the All-Payer Claims Database and the data submitted thereto in facilitating data-driven, evidence-based improvements in access, quality, and cost of health care in the Commonwealth. The bill requires the Bureau to submit a report of its findings and recommendations to the Governor and General Assembly no later than December 1, 2026.

Head Start State Collaboration Office; state of Head Start and Early Head Start in the Commonwealth; report. Requires the Head Start State Collaboration Office at the Department of Education, no later than December 1, 2026, to develop and recommend to the Commission on Early Childhood Care and Education for endorsement a report summarizing the state of Head Start and Early Head Start in the Commonwealth that is required to address several topics enumerated in the bill.

Prior authorization; requiring physician review for denial. Prohibits a health insurance carrier from making an adverse determination of a prior authorization request (i) for prescription drugs unless such denial has been reviewed and approved by a licensed physician or, if a licensed physician is not available, by a licensed pharmacist or (ii) for health care services unless such adverse determination has been reviewed and approved by (a) a licensed physician; (b) in the case of mental health services, a licensed mental health provider if a licensed physician is unavailable; or (c) in the case of dental services, a licensed dentist if a licensed physician is unavailable.

Commonwealth Health Reinsurance Program; extension of program; percentage goal to decrease premium. Directs the State Corporation Commission to apply to the appropriate federal agencies under the federal Patient Protection and Affordable Care Act for an extension of the existing State Innovation Waiver authorizing the Commonwealth to implement a reinsurance program. The existing State Innovation Waiver is set to expire on January 1, 2028. Additionally, the bill removes the 20 percent upper limit of the premium reduction goal under the Commonwealth Health Reinsurance Program. As introduced, this bill was a recommendation of the Health Insurance Reform Commission.

Health insurance; prohibited restrictions on in-network referrals. Prohibits a health insurance carrier from prohibiting an in-network provider, as defined in the bill, from referring any enrollee or specimen to any in-network clinical laboratory or in-network pathology service provider under the terms of such insurance unless such referral would constitute a violation of certain laws. This bill is identical to SB 745.

Department of Medical Assistance Services; state plan for medical assistance; provider-to-provider consultation; telemedicine. Specifies that the Medicaid provision for provider-to-provider consultation includes payment for consultations provided through telemedicine services. This bill incorporates HB 87.