Healthcare (Mental Health)

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.

Health insurance; reimbursement rates. Requires health insurance carriers to reimburse in-network providers for covered mental health services and outpatient treatment at rates negotiated between the health carrier and the in-network provider, provided that such rates are no less than 100 percent of the applicable reimbursement rate under Medicare for the same provider and service.

Public schools; mental health awareness training and instruction; requirements. Requires each teacher and other relevant personnel, as determined by the applicable school board, employed on a full-time basis to complete mental health awareness training that addresses the needs of youth populations that are at a high risk of experiencing mental health challenges and disorders in accordance with evidence-based best practices developed by the American Psychological Association. Current law requires such teachers and personnel to complete mental health awareness training but does not contain any requirements relating to the specific topics such training must address. The bill prohibits any of its provisions or any policy adopted in accordance with its provisions from being construed to permit biased or discriminatory treatment of any youth population deemed to be at a high risk of experiencing mental health challenges and disorders.

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.

Commissioner of Behavioral Health and Developmental Services; duties; Problem Gambling Treatment and Support Advisory Committee; appointment of members. Requires the Commissioner of Behavioral Health and Developmental Services to appoint two additional members of the Problem Gambling Treatment and Support Advisory Committee: an employee of the Department of Behavioral Health and Developmental Services who specializes in recovery and treatment services and a representative from the Virginia State Police Gaming Enforcement Unit.

Constitutional amendment (second reference); fundamental right to reproductive freedom. Provides that every individual has the fundamental right to reproductive freedom and that such right shall not be, directly or indirectly, denied, burdened, or infringed upon unless justified by a compelling state interest, as defined in the amendment, and achieved by the least restrictive means. The amendment specifies that, notwithstanding the other provisions of the amendment, the Commonwealth may regulate the provision of abortion care in the third trimester, provided that in no circumstance shall the Commonwealth prohibit an abortion (i) that in the professional judgment of a physician is medically indicated to protect the life or physical or mental health of the pregnant individual or (ii) when in the professional judgment of a physician the fetus is not viable.

Programs for at-risk students; permissible uses of funding. Includes as covered programs that are eligible for funding under the At-Risk Program initiatives to support both the physical and mental health of students in public schools, including the hiring of licensed practical nurses, registered nurses, and advanced practice registered nurses. This bill is a recommendation of the School Health Services Committee and is identical to HB 195.

Employment; paid sick leave; civil penalties; civil actions. Requires one hour of paid sick leave for every 30 hours worked for all employees of private employers and state and local governments, with certain exceptions. The bill requires that employees who are employed and compensated on a fee-for-service basis accrue paid sick leave in accordance with regulations adopted by the Commissioner of Labor and Industry. The bill provides that employees transferred to a separate division or location remain entitled to previously accrued paid sick leave and that employees retain their accrued paid sick leave under any successor employer. The bill allows employers to provide a more generous paid sick leave policy than prescribed by its provisions and specifies that employees, in addition to using paid sick leave for their physical or mental illness or to care for a family member, may use paid sick leave to seek or obtain certain services or to relocate or secure an existing home due to domestic abuse, sexual assault, or stalking. The bill requires the Commissioner to promulgate regulations for the implementation and enforcement of the bill's provisions by July 1, 2027.The bill authorizes the Commissioner, in the case of a knowing violation, to subject an employer to a civil penalty not to exceed $150 for the first violation, $300 for the second violation, and $500 for each successive violation. The Commissioner or Attorney General may commence administrative proceedings or bring a civil action to enforce the bill's provisions. Additionally, the bill authorizes an aggrieved employee to bring a civil action against the employer in which he may recover double the amount of any unpaid sick leave and the amount of any actual damages suffered as the result of the employer's violation. Certain provisions of the bill have a delayed effective date of July 1, 2027. This bill is identical to SB 199.

Constitutional amendment (second reference); fundamental right to reproductive freedom. Provides that every individual has the fundamental right to reproductive freedom and that such right shall not be, directly or indirectly, denied, burdened, or infringed upon unless justified by a compelling state interest, as defined in the amendment, and achieved by the least restrictive means. The amendment specifies that, notwithstanding the other provisions of the amendment, the Commonwealth may regulate the provision of abortion care in the third trimester, provided that in no circumstance shall the Commonwealth prohibit an abortion (i) that in the professional judgment of a physician is medically indicated to protect the life or physical or mental health of the pregnant individual or (ii) when in the professional judgment of a physician the fetus is not viable.