Healthcare

Maternal Health Monitoring Pilot Program established; report. Directs the Department of Health to implement the Maternal Health Monitoring Pilot Program that provides for remote patient monitoring for maternal hypertension and maternal diabetes. The bill requires the Department to select a managed care organization and technology vendor to administer the Pilot Program and to submit a report to the Governor and General Assembly no later than 18 months after the first eligible participant is enrolled in the Pilot Program.

Breakthrough Therapies for Veteran Suicide Prevention Act; fund and council established; report. Establishes the Breakthrough Therapies for Veteran Suicide Prevention Fund (the Fund) to provide funding to support clinical research and implementation of FDA Breakthrough Therapies, defined in the bill, for the treatment of post-traumatic stress disorder, treatment-resistant depression, major depressive disorder, and traumatic brain injury. Under the bill, the Fund shall be used to (i) establish public-private partnerships to jointly fund Phase III clinical trials of FDA Breakthrough Therapies; (ii) conduct investigator-initiated clinical trials; (iii) establish a compassionate use program; (iv) create education and training opportunities for mental health professionals; (v) begin patient access pilot programs; and (vi) conduct implementation studies for best practices, cost-effectiveness, and methods to reduce treatment costs. The bill also establishes the Breakthrough Therapies for Veteran Suicide Prevention Advisory Council to advise the Department of Health on administration of grant funding or contracting to carry out the purposes of the Fund. Finally, the bill requires the Board of Pharmacy to amend its regulations to designate, reschedule, or deschedule a controlled substance in accordance with federal law after the expiration of 30 days from the publication in the Federal Register of a final or interim final order or rule.

A BILL to amend the Code of Virginia by adding a section numbered 54.1-2971.2, relating to physicians; informed consent; disclosure of certain information prior to hysterectomy or oophorectomy.

Department of Behavioral Health and Developmental Services; Early Intervention Program for Infants and Toddlers with Disabilities; program extension. Directs the Department of Behavioral Health and Developmental Services to take all steps necessary to implement the federal extension option for the federal Early Intervention Program for Infants and Toddlers with Disabilities to allow children five years of age or younger to receive services through such program.

Virginia National Guard TRICARE Reimbursement Fund established. Establishes the Virginia National Guard TRICARE Reimbursement Fund for the purpose of reimbursing the costs of federal TRICARE dental insurance plan premiums and TRICARE Reserve Select health insurance plan premiums for Virginia National Guard members deemed eligible by the Adjutant General.

State pharmacy benefits manager; contractual provisions; report. Requires the Department of Medical Assistance Services' contract with the state pharmacy benefits manager to (i) require that that ingredient-cost reimbursement is based on the national average drug acquisition cost, or if unavailable, the wholesale acquisition cost minus a discount set by the Department, plus a professional dispensing fee, determined by the Department; (ii) require real-time or near real-time transparency in drug costs, rebates collected and paid, dispensing fees paid, administrative fees, and all other charges, fees, costs, and holdbacks, claim denials appeals, and network participation; (iii) prohibit the state pharmacy benefits manager from steering Medicaid recipients to affiliated pharmacies through differential cost-sharing, restrictive network design, or the mandatory use of a mail order pharmacy provider; (iv) require the state pharmacy benefits manager to (a) meet network adequacy standards established by the Department; (b) allow any willing pharmacy to participate in the pharmacy network; (c) verify that all contracted pharmacies are actively accepting Medicaid recipients; (d) submit annual reports containing certain information; (e) disclose to the Department pricing and maximum acquisition cost methodologies; and (f) allow invoice-based or national average drug acquisition cost-based appeals and require an adjustment of rates network-wide when an appeal is upheld; and (v) include enforcement mechanisms and monetary penalties for noncompliance. Additionally, the bill requires Department to annually calculate the savings generated by the use of the state pharmacy benefits manager and to annually increase its dispensing fee by the amount of such savings. The bill requires the Department to annually (1) publish and make available on its website its annual and total savings achieved, the annual and total amount applied to dispensing fees increases, and the updated dispensing fees and (2) report to the General Assembly on the state pharmacy benefits manager's compliance, national average drug acquisition cost compliance, pharmacy reimbursement trends, network adequacy compliance, and dispensing fee sufficiency.

Virginia Fire Personnel and Equipment Grant Program established; report. Establishes the Virginia Fire Personnel and Equipment Grant Program (the Program) for the purpose of awarding grants to localities to hire additional firefighters and to improve their firefighting and emergency medical services. The bill specifies that the Department of Fire Programs (the Department) shall administer the Program and two types of grants shall be made from the Program. The first shall provide grants to localities to increase the number of firefighters. Such grants shall be made for up to three years and shall be used by localities for programs to (i) hire new, additional full-time firefighters; (ii) convert part-time or volunteer firefighters to full-time firefighters; or (iii) recruit and retain volunteer firefighters. The second shall award grants to localities for improving firefighting and emergency medical services, including by acquiring firefighting and emergency medical services vehicles and equipment and modifying facilities. For both grants, the bill provides that funds shall not be used to supplant any funds currently provided by the Commonwealth or by the locality and shall be used to increase the total amount of funds available for the provision of firefighting or emergency medical services. The bill requires the Department to submit a report annually, beginning November 1, 2027, to the Governor and the General Assembly containing a list of grants, the amount of each approved grant, information on the performance assessment system that the bill directs the Department to create, an evaluation of each grant based on such system, and any other criteria deemed relevant by the Department.

Department of Behavioral Health and Developmental Services; Early Childhood Mental Health Consultation Program established; pilot programs; development of modules; report. Establishes the Early Childhood Mental Health Consultation Program, to be administered by the Department of Behavioral Health and Developmental Services (the Department) in coordination with the Department of Education and the Department of Health, for the purpose of providing and expanding the accessibility of early childhood mental health consultation services, as that term is defined in the bill. The bill requires, pursuant to the Program, early childhood mental health consultation services shall be provided to families of children three through five years of age who exhibit developmental delays and behavioral health concerns and to early childhood care and education programs as enumerated in the bill. The bill requires the Department, in administering the Program, to (i) develop, or contract with community services boards to develop, and make available to early childhood care and education programs and providers developmental readiness modules, in accordance with the requirements of the bill; (ii) designate three pilot regions for initial implementation of the Program, with implementation beginning no later than January 1, 2027; and (iii) submit to the Governor and the General Assembly by November 1 of each year a report on the implementation and outcomes of the Program for each pilot region selected for initial implementation. The provisions of the bill relating to initial implementation of the Program in the pilot regions shall expire on July 1, 2029.

Health Care Decisions Act; patients incapable of making informed decisions; absence of next of kin. Authorizes, for purposes of the Health Care Decisions Act, the patient care consulting committee to make health care decisions for a patient incapable of making informed decisions when no next of kin is reasonably available.

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.