Healthcare (Hospitals)

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 incorporates SB 434 and is identical to HB 1007.

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.

Department of Behavioral Health and Developmental Services; individuals receiving services; right to send and receive mail. Allows state facilities operated by the Department of Behavioral Health and Developmental Services to process sealed letter mail for electronic delivery. This bill is identical to SB 580.

Weapons; possession prohibited in a hospital that provides mental health services or developmental services; penalty. Makes it a Class 1 misdemeanor for any person to knowingly and intentionally possess in the building of any hospital that provides mental health services or developmental services in the Commonwealth, including an emergency department or other facility rendering emergency medical care, a (i) firearm, (ii) knife with a blade over three and one-half inches, or (iii) other dangerous weapon, including explosives and stun weapons. The bill also provides that notice of such prohibitions shall be posted conspicuously at each public entrance of any hospital and that no person shall be convicted of the offense if such notice is not posted, unless such person had actual notice of the prohibitions. The bill provides that such firearm, knife, explosive, or weapon shall be subject to seizure by a law-enforcement officer and forfeited to the Commonwealth and specifies certain exceptions to the prohibition. This bill is identical to SB 173.

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.

Hospitals; psychiatric emergency departments. Allows hospitals with psychiatric emergency departments located in the City of Hampton to operate without a physician on duty when certain conditions are met, including having written agreements in place with emergency medical service providers and being immediately adjacent to a non-psychiatric emergency department. The bill requires such psychiatric emergency departments to submit treatment data to the General Assembly on an annual basis by November 1. This bill is identical to HB 1318.

Weapons; possession prohibited in a hospital that provides mental health services or developmental services; penalty. Makes it a Class 1 misdemeanor for any person to knowingly and intentionally possess in the building of any hospital that provides mental health services or developmental services in the Commonwealth, including an emergency department or other facility rendering emergency medical care, a (i) firearm, (ii) knife with a blade over three and one-half inches, or (iii) other dangerous weapon, including explosives and stun weapons. The bill also provides that notice of such prohibitions shall be posted conspicuously at each public entrance of any hospital and that no person shall be convicted of the offense if such notice is not posted, unless such person had actual notice of the prohibitions. The bill provides that such firearm, knife, explosive, or weapon shall be subject to seizure by a law-enforcement officer and forfeited to the Commonwealth and specifies certain exceptions to the prohibition. This bill is identical to HB 229.

Hospital price transparency; price comparison tool; penalties for noncompliance. Directs the Department of Health to establish a hospital price transparency comparison tool based on the information hospitals provide under existing law and the information available through the Virginia All-Payer Claims Database. The bill specifies that the list of standard charges provided by the hospital controls in the event of a dispute between a hospital and a patient over a patient payment amount and requires hospitals to discharge debt and not require payment for any elective procedure, test, or service for which the patient payment amount is disputed and there is not a standard charge made available to the public on the hospital's website on the date such elective procedure, test, or service is performed.

Certificate of public need; expedited review of certain projects; duties of the State Health Services Plan Task Force. Directs the State Health Services Plan Task Force to develop recommendations for designating areas of the state with an identifiable need for additional projects, taking into account numerous barriers of access to health care. The bill also directs the Board of Health to promulgate updated regulations for expedited application and review processes for certain projects. This bill is identical to HB 1337.

Health insurance; pharmacy benefits managers; requirements and prohibited conduct; retail pharmacy network access standards; enforcement; civil penalty. Amends the definition of "pharmacy benefits management" to exclude certain activities and amends certain provisions related to prohibited conduct by health carriers and pharmacy benefits managers (PBMs). The bill prohibits a health carrier or PBM from denying a pharmacy the opportunity to participate in a network at preferred status if the pharmacy is willing to accept the same terms and conditions as other pharmacies that receive preferred status. The bill prohibits a health carrier or PBM from retroactively denying or reducing reimbursement for a covered service claim, except in certain circumstances. The bill also prohibits health carriers and PBMs from failing to make a payment due to a pharmacy or pharmacist upon termination from a network and from charging a pharmacist or pharmacy a fee related to participation in a PBM's network. Under the bill, no PBM shall restrict a pharmacy from informing an individual of any differential between the individual's out-of-pocket costs and the amount the individual would pay to purchase the drug directly or through the individual's health insurance coverage. The bill also requires PBMs to establish and maintain an electronic claim inquiry processing system using national standards to provide certain disclosures and to maintain records of network development activities. The bill prohibits a PBM from including the name of any pharmacy or hospital in any material issued by the PBM unless it lists all pharmacies participating in the preferred and nonpreferred pharmacy and health networks. Under the bill, the Attorney General is authorized to issue civil investigative demands regarding violations of the provisions of the bill and to bring an action in circuit court to enjoin any violation of such provisions. If the court finds that a person has willfully violated the provisions of the bill, the Attorney General may assess a civil penalty of up to 5,000 per violation.