Use of artificial intelligence system by mental health service providers; civil penalty. Permits the use of an artificial intelligence system by mental health service providers to assist in providing therapy or counseling services if such mental health service provider maintains full responsibility for all interactions, outputs, and data use associated with the system. The bill prohibits the use of an artificial intelligence system to provide therapy or counseling services without a mental health service provider. The bill specifies that records kept by mental health service providers must comply with health records privacy requirements; creates an exception for religious counseling, peer support, or self-help materials and educational resources; and establishes a civil penalty not to exceed $10,000 for violations of the statute.
Nursing homes; periodic medical visits and resident assessments. Requires all nursing homes to notify the resident of a nursing home, the resident's family, and the Department of Health if a federally required physician visit does not take place. The bill also requires each nursing home to conduct a comprehensive assessment on an annual basis to determine each resident's needs and describe each resident's capability to perform daily life functions. Such assessments must be reviewed at least once every 92 days, and more frequently in the event of a significant change in the resident's physical or mental condition.
Health carriers; use of artificial intelligence; disclosures. Requires health carriers to disclose to the State Corporation Commission's Bureau of Insurance how artificial intelligence is used to manage claims coverage and to submit all information enabling decisions made by artificial intelligence to the Bureau upon request. The bill also requires health carriers to provide notice to enrollees and health care providers when artificial intelligence has been used to issue an adverse determination and to provide a clear and timely process for appeal of such determination.
Constitutional amendment (voter referendum); fundamental right to reproductive freedom. Provides for a referendum at the November 3, 2026, election to approve or reject an amendment to the Constitution of Virginia relating to the right to make one's own decisions related to reproductive health care, including access to abortion. The amendment protects patients and their doctors and nurses from being punished for making such decisions. The amendment allows the state to place restrictions on access to abortion during the third trimester of pregnancy except when the patient's life or physical or mental health is at risk or the pregnancy cannot survive. This bill is identical to HB 781.
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.
Department of Medical Assistance Services; community health worker expansion. Directs the Department of Medical Assistance Services, in coordination with the Department of Health, Department of Social Services, Department of Behavioral Health and Developmental Services, and Department for Aging and Rehabilitative Services, to (i) evaluate opportunities for Medicaid managed care organizations to embed certified community health workers into care coordination models, (ii) evaluate the implementation of 2024 Medicare Community Health Integration services codes, (iii) develop and implement statewide workforce pathways for community health worker training, and (iv) identify opportunities to expand the use of community health workers in programs supporting high-cost Medicaid populations. The bill directs the Department of Medical Assistance Services to submit a report of its findings and recommendations to the Joint Commission on Health Care and the Chairs of the House Committee on Appropriations and Senate Committee on Finance and Appropriations no later than December 1, 2026.
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.
Line of Duty Act; transitional coverage. Requires the Department of Human Resource Management to acquire and provide temporary transitional health insurance coverage to disabled persons, eligible spouses, and eligible dependents during the period of transition into the LODA (Line of Duty Act) Health Benefits Plans. Current law authorizes but does not require the Department to acquire and provide such temporary transitional health insurance coverage to disabled persons, eligible spouses, and eligible dependents during such period.
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.
