The Medical Society of Virginia (MSV) is devastated to receive the news of the car accident that resulted in the death of Hailey Green and critical condition of Dr. Hughes Melton, a longtime MSV member. MSV expresses its deepest sympathies to Ms. Green’s family and friends. Our thoughts and prayers are with Dr. Melton and his loved ones as he receives treatment at UVA’s Medical Center.
During the 2019 General Assembly session, MSV supported HB 2515 and SB 1596 and played a significant role in these bills becoming Virginia legislation.
HB 2515, carried by Del. Tim Hugo (R-Centreville) and SB 1596, carried by Sen. Siobhan Dunnavant (R-Henrico) are bills requiring any insurance carrier in the Commonwealth to count any payments made by another person on the enrollee’s behalf, including prescription drug coupons, toward a patient’s out-of-pocket maximum or cost-sharing requirement. They’ve been approved by the General Assembly and have been signed in to law by the Governor.
The Virginia Mercury released an article about these bills March 26,2019.
By Katie O’Connor
Increasingly, as drug prices inch upwards, patients are relying more on coupons they receive directly from pharmaceutical manufacturers to cover the cost of their drugs.
But health insurers have developed a tactic that essentially negates that benefit by refusing to count the value of the coupon or copay assistance toward the patient’s deductible.
Thanks to two bills that made their way successfully through the General Assembly and received the governor’s signature last week, though, health insurers will have to count any payments made on an enrollee’s behalf toward their deductible.
According to Fair Health Care VA, a patient advocacy group, Virginia is the first state to take action to address the issue.
“Patients should not be denied one of the key benefits of copay assistance programs, particularly since insurers are already getting the value of negotiated drug price discounts while withholding these benefits from patients,” Dr. Bruce Silverman, a Richmond nephrologist and member of Fair Health Care VA, said in a statement.
Nearly one in five major employers do not count coupons and copay assistance programs toward a patient’s deductible, the group says.
Del. Timothy Hugo, R-Fairfax, and Sen. Siobhan Dunnavant, R-Henrico, carried the legislation, which requires “any carrier issuing a health plan in the commonwealth to count any payments made by another person on the enrollee’s behalf, as well as payments made by the enrollee, when calculating the enrollee’s overall contribution to any out-of-pocket maximum or any cost-sharing requirement under the carrier’s health plan.”
Gov. Ralph Northam signed the bills last week, around the same time he also signed legislation that will require health insurers to create shared savings programs. The programs are designed to give patients incentives to choose lower-cost health options because they’ll share in some of the savings with their insurer. It also includes a transparency component so patients can log onto their insurer’s website and compare costs. Dunnavant and Del. Kathy Byron, R-Bedford, carried the bills.
But Northam also axed several other bills related to short-term and catastrophic health plans that Republicans see as a potential alternative to high costs. Opponents have argued that the plans’ meager benefits put patients unnecessarily at risk, while proponents claim they’re an inexpensive alternative for healthy individuals.
In a statement, Northam said he vetoed the bills because they “put Virginians at risk of being underinsured, result in rapidly increasing marketplace premiums, and undermine key protections in the Affordable Care Act.”
Thank you to our members, specialty and local society presidents, members and staff, and partnering groups for your commitment to the work required to make this year’s session successful.
Read an update from this week below. A full 2019 legislative wrap-up will be distributed in the spring issue of MSV’s printed newsletter.
Due to the leadership of Del. Scott Garrett, MD and Sen. Emmett Hanger, the General Assembly approved a budget that includes a provision to raise Medicaid reimbursement rates to 70% of Medicare rates. This amendment would impact anesthesia, primary and preventive care, and emergency care, which are all currently below 70% of Medicare rates.
The budget will now go to the Governor.
MSV’s priority prior authorization legislation, SB 1607 (Dunnavant) is on its way to the Governor’s desk for signature. This is a huge victory for physicians and patients. The bill would streamline medication prior authorizations. It would also ensure payment for pre-approved surgeries and invasive procedures; during an approved procedure, if a physician provided appropriate additional medical care, they would be reimbursed without requiring an additional authorization.
HB 2126 (Davis) would reform step therapy and would improve clinical criteria as well as create expedient exemptions processes for patients already on an effective treatment or with an urgent need. HB 2126 has passed the General Assembly and awaits the Governor’s signature. Thank you for those that sent messages to legislators emphasizing this as a priority issue for Virginia’s patients!
Despite unified support from the physician, hospital, and patient communities, SB 1763 (Sturtevant) was killed due to health plan opposition and lobbying.
SB 1763 (Sturtevant) would have prohibited balance billing for emergency care and required physicians be paid the regional commercial average payment directly. It would have strengthened the prudent layperson standard by requiring the plans to cover the emergency care, regardless of the final diagnosis.
Physicians and patients will need to continue this partnership over the coming months to encourage legislators to adopt a practical solution to end emergency balance billing. Stay tuned for next steps you can take in the coming weeks.
HB 2515 (Hugo) and SB 1596 (Dunnavant) co-pay accumulator bills are now on the Governor’s desk for signature.
These bills would require any insurance carrier in the Commonwealth to count any payments made by another person on the enrollee’s behalf, including prescription drug coupons, toward a patient’s out-of-pocket maximum or cost-sharing requirement.
Both HB 1952 (Campbell) and SB 1209 (Peake) have been sent to the Governor for signature. Both bills will make administrative updates to Physician Assistant practice, bringing Virginia’s code in line with current Board of Medicine regulations. MSV has worked closely with our Physician Assistant members as well as the Virginia Academy of Physician Assistants to get these bills passed. The Governor has signed SB 1209 into law and has HB 1952 on his desk, awaiting his signature.
SB 1619 (Obenshain) This bill initially proposed creating a duty to preserve evidence that may be relevant to a reasonably foreseeable lawsuit, which aligns with federal rules. The bill moved through the process unamended until the end when a reenactment clause was added by the House Committee at the patron’s request. This sent the bill into conference committee, where the patron put forth significant changes. The proposed substitute provides jury instruction allowing a negative presumption even when the evidence was accidentally lost or destroyed in a regular course of business. This is significant because it applies to litigation that has not been filed yet but is “reasonably foreseeable.” MSV and other stakeholders are working to defeat the proposed substitute and keep the bill in its original form.
This week MSV joined Del. Sam Rasoul, representatives from the Richmond Academy of Medicine, Carilion Clinic, Virginia Hospital and Healthcare Association, American Board of Medical Specialties, Virginia Department of Health, and the American Association of Physician and Surgeons to discuss concepts and concerns with HB 1967. MSV will continue to work to address physicians’ concerns with MOC at both a state and national level.
SB 1727 (Norment) and HB 2748 (Stolle) increases the minimum age to 21 years old to sell, purchase or possess tobacco products, nicotine vapor products, and alternative nicotine products. Both bills have been signed into law by the Governor.
HB 2026 (Stolle) would include a screening for congenital cytomegalovirus in newborns who fail the initial newborn hearing screen. The bill has passed the House and Senate and is on its way to the Governor’s desk for signature.
The 2019 session is in the final stretch but there are still important bills that need your support.
See this week’s updates and how to help.
ACTION NEEDED – SEND A MESSAGE AND SHARE WITH 5 COLLEAGUES
Thank you to the leadership of Del. Scott Garrett, MD and Sen. Emmett Hanger who submitted budget amendments to increase Medicaid reimbursement rates for physicians. The Senate ultimately voted to include a budget amendment that would raise Medicaid reimbursement rates to 70% of Medicare rates. This amendment would impact anesthesia, primary and preventive care, and emergency care, which are all currently below 70% of Medicare rates. The House did not include an increase in its proposed budget.
The Senate and House named their “budget conferees” that will craft the final budget. Since the House did not include the increase in its budget, it is critical that Delegates know how important this increase will be in improving access to care for Medicaid recipients. Get more information here.
Delegates must hear from you or we risk losing any current or future legislation concerning Medicaid rates.
SB 1763 (Sturtevant) is supported by the entire physician community, hospitals, and patients and is the only bill that remains on emergency balance billing.
The bill would prohibit balance billing for emergency care and require physicians be paid the regional commercial average payment directly. In addition, it strengthens the prudent layperson standard by requiring the plans to cover the emergency care, regardless of the final diagnosis. The bill is currently in House Appropriations Committee.
This session has awarded the House of Medicine some great wins so far, but it is important to keep pressure on the remaining bills so they can make it across the finish line!
MSV’s priority prior authorization legislation, SB 1607 (Dunnavant), passed the House Commerce and Labor Committee on Wednesday and will now move to the House floor for consideration. This is a huge victory for physicians and patients. The bill would streamline medication prior authorizations. It would also ensure payment for pre-approved surgeries and invasive procedures; during an approved procedure, if a physician provided appropriate additional medical care, they would be reimbursed without requiring an additional authorization.
HB 2126 (Davis) would reform step therapy and would improve clinical criteria as well as create expedient exemptions processes for patients already on an effective treatment or with an urgent need. On Monday, the bill will be heard in Senate Commerce and Labor Committee and legislators need to hear from you! Easily send a pre-drafted message to your legislator now.
Both HB 1952 (Campbell) and SB 1209 (Peake) have passed the House and Senate and have been sent to the Governor for signature. Both bills will make administrative updates to Physician Assistant practice, bringing Virginia’s code in line with current Board of Medicine regulations. MSV has worked closely with our Physician Assistant members as well as the Virginia Academy of Physician Assistants to get these bills passed!
HB 2515 (Hugo) and SB 1596 (Dunnavant) co-pay accumulator bills have passed House and Senate and are on their way to the Governor’s desk for signature.
These bills would require any insurance carrier in the Commonwealth to count any payments made by another person on the enrollee’s behalf, including prescription drug coupons, toward a patient’s out-of-pocket maximum or cost-sharing requirement.
SB 1727 (Norment) and HB 2748 (Stolle) increases the minimum age to 21 years old to sell, purchase or possess tobacco products, nicotine vapor products, and alternative nicotine products. Both bills have passed and are awaiting the Governor’s signature.
HB 2026 (Stolle) would include a screening for congenital cytomegalovirus in newborns who fail the initial newborn hearing screen. The bill has passed Senate and will now move to Conference Committee to be finalized.
Here are five simple ways to help you maximize your patients’ health and make a concerted effort at management and prevention of such chronic diseases as type 2 diabetes and hypertension.
According to the Centers for Disease Control and Prevention (CDC), 84 million adults have prediabetes. But the good news is that prediabetes is often times a reversible condition. So it’s important that you screen patients to determine who may be at risk.
To make it easier for physicians to screen patients, the CDC and the American Medical Association developed the Prevent Diabetes STAT toolkit. The toolkit encourages physicians to:
Once you’ve identified patients who have prediabetes, their participation in a lifestyle change program that is part of the National Diabetes Prevention Program (National DPP) becomes vital to their success.
Study results reveal that participation in a lifestyle change program that included counseling and motivation support on proper physical activity, diet and behavioral changes lowered participants’ risk of developing type 2 diabetes by 58 percent. And for those aged 60 years and older, the risk was reduced by 71 percent.
Talk with your patients about how lifestyle change programs work and what the benefits of joining a DPP are. The Prevent Diabetes STAT toolkit includes helpful handouts and additional resources that can help you educate patients on the importance of it and how to partner with DPP providers in your community.
New comprehensive hypertension guidelines have been released with key recommendations on the diagnosis, treatment and prevention of the condition.
The new lower target for blood pressure treatment is now 130/80 mmHg for most patients, which stresses the need for early detection, prevention and treatment to reduce the risk of future cardiovascular events.
By better understanding how the new guidelines work in practice, you can best serve your patient population and help to keep high blood pressure under control.
If you’re committed to taking action to help manage your patients’ rates of hypertension, the BP Improvement Program can serve as a great resource.
This evidence-based guide highlights three critical areas:
When you work with your patients to improve their blood pressure control, you improve their quality of care and also help lower their risk of heart attack, stroke and death.
As you encourage and support your patients in having a healthier lifestyle, it’s also important that they have the support of loved ones as well. Encourage all family members to work together to get healthy.
Suggest that they prepare healthy meals together, do fun physical activities together and spend time connecting as a family unit. That added support system makes it more likely that they will be successful and reinforces the importance of health for the rest of the family and encourages healthy habits that will last throughout the year.
Thank you to all of our physicians, physician assistants, and medical students who participated in our January White Coats on Call Lobby Day! Over 100 doctors, PAs, and medical students visited with over 65 legislators to advocate for the practice of medicine and patients in Virginia.
The GA saw great progress with several important bills before the legislature this week – but we need your support. See this week’s updates and how to help.
Del. Scott Garrett, MD and Sen. Emmett Hanger submitted budget amendments (303 #23h and 303 #4s) that would increase Medicaid reimbursement rates for physicians currently reimbursed below 75% of Medicare. This is the one of the most significant pieces of legislation to impact access to care for Virginia patients. With the House and Senate budgets being announced on Sunday, all members of the General Assembly, must hear from you immediately. Get more information on our website.
MSV is working with the entire physician, patient, and hospital community to advocate for patient-friendly solutions that also secure reasonable and sustainable reimbursements. The health plans have blocked our efforts to protect patients in this legislation. We are down to one bill that is supporting these efforts: SB 1763 (Sturtevant).
SB 1763 (Sturtevant) addresses emergency balance billing; the bill would protect patients from balance billing and ensure physicians are paid directly. In addition, the bill would pay providers a fair and reasonable amount. SB 1763 is supported by the entire physician community, patient groups, and the Virginia Hospital and Healthcare Association (VHHA). This week it passed the Senate Commerce and Labor Committee and Senate Finance Committee and will now head to the Senate floor for a vote. The opposing bill (Wagner), was defeated by the Medical Society and health care community fighting for our patients. SB 1763 is now the only bill in the Senate that reforms emergency balance billing.
HB 1714 (Ware) was the House version of this bill and successfully reported out of House Commerce and Labor Committee this week but was sent to the House Committee on Appropriations due to Anthem raising speculative financial concerns about the state employee health plan. Anthem applied substantial pressure of future risk which resulted in the Appropriations Committee deciding to not hear the bill; therefore the bill is now dead despite the physician, hospital, and patient community fighting together for a patient-friendly solution.
SB1727 (Norment) and HB2748 (Stolle) increase the minimum age for persons prohibited from purchasing or possessing tobacco products, nicotine vapor products, and alternative nicotine products, and the minimum age for persons such products can be sold to, from 18 years of age to 21 years of age. These bills have passed their respective bodies and have crossed over.
HB 2026 (Stolle) would include a screening for congenital cytomegalovirus in newborns who fail the initial newborn hearing screen. The bill passed out of House Appropriations Committee and is now on the House floor.
This week, the House of Medicine had significant victories. Next week is Crossover, which is the halfway point for session. After February 5, each body can only consider legislation from the other body. It is important to keep pressure on these bills, so that their initial wins can make it across the finish line.
HB 2515 (Hugo) and SB 1596 (Dunnavant) Co-pay Accumulator bills, both passed out of their respective committees. These bills would require any insurance carrier in the Commonwealth to count any payments made by another person on the enrollee’s behalf, including prescription drug coupons, toward a patient’s out-of-pocket maximum or cost-sharing requirement.
HB 2544 (Byron) Emergency balance billing bill, which would have given insurance companies unilateral authority to establish rates with no transparency, ultimately limiting patient access to emergency care, died this week in House Commerce and Labor Committee.
HB 2543 (Byron) ancillary services balance billing bill was struck by the patron this week. This bill would have applied onerous requirements on the referring and treating physicians before the patient could receive treatment or services.
MSV’s priority prior authorization legislation, SB 1607 (Dunnavant), passed Senate Commerce and Labor Committee and will now move to the Senate floor. This is a huge victory for physicians and patients.
The bill would also ensure payment for pre-approved surgeries and invasive procedures; during an approved procedure, if a physician provided appropriate additional medical care they would be reimbursed without requiring an additional authorization.
HB 2126 (Davis) would reform step therapy and would improve clinical criteria as well as create expedient exemptions processes for patients already on an effective treatment or with an urgent need. This bill passed House Commerce and Labor and will now advance to the House floor.
HB 1952 (Campbell) passed the House and will now move to the Senate. SB 1209 (Peake) has passed the Senate and has moved to the House. Both bills would make administrative updates to Physician Assistant practice, bringing Virginia’s code in line with current Board of Medicine regulations. MSV has been working closely with our Physician Assistant members as well as the Virginia Academy of Physician Assistants to support this effort.
Virginia Medicaid implemented a Common Core Formulary – a “core” list of covered drugs for all Medicaid members enrolled with the Fee-for-Service, Medallion 4.0 and Commonwealth Coordinated Care Plus (CCC Plus) Managed Care programs across the Commonwealth – effective on December 1, 2018.
The Common Core Formulary includes all the “preferred” drugs on DMAS’ Preferred Drug List (PDL) in approximately 90 therapeutic drug classes. Medallion 4 and CCC Plus health plans are contractually required to cover all “preferred” drugs on Virginia Medicaid’s PDL/Common Core Formulary and cannot place additional restrictions (such as prior authorizations, step therapies, quantity limits, etc.) on the “preferred” drugs. The Medicaid managed care health plans may add drugs to therapeutic drugs classes on the DMAS PDL/Common Core Formulary but cannot remove drugs.
DMAS PDL/Common Core Formulary “Quick List” of Preferred Medications
Additional provider information including service authorization forms and a drug look-up tool.
The Medicaid health plans will accept the DMAS/Magellan service authorization from this website for any of the preferred medications.
It is important to note that the DMAS PDL/Common Core Formulary does not apply to Medicaid members that receive Medicare benefits and full Medicaid benefits (dual eligibles). The drug benefits for dual eligibles members are defined by the member’s Medicare Part D plan.
The DMAS PDL is not a comprehensive formulary, so the health plans’ formularies will be more extensive. For therapeutic drug classes not included on the DMAS PDL (e.g., oral oncology drugs, HIV drugs, etc.), each health plan will publish a formulary with the plan’s covered drugs.
DMAS has established a mailbox for providers to send questions or concerns regarding Common Core Formulary drug coverage.
Issues related to drug coverage and/or denials for preferred drugs on the DMAS PDL should be sent to [email protected].
Two top priority issues are now before the legislature that need your support. See this week’s updates and how you can help.
Medicaid Reimbursement Rates
Del. Scott Garrett, MD and Sen. Emmett Hanger submitted budget amendments (303 #23h and 303 #4s) that would increase Medicaid reimbursement rates for physicians currently reimbursed below 75% of Medicare. The budget amendments will first be considered by the Senate Finance and House Appropriations Committees. At this critical point, these committee members, as well as all members of the General Assembly, must hear from you to include the amendments in the final budget proposal. This is a critical and urgent opportunity. Call and send a message now. Get more information on our website.
Surprise/Balance Billing
On Thursday, MSV and physician specialty groups attended the House Commerce and Labor subcommittee balanced billing hearing. This year, balanced billing has been a hot topic before the General Assembly and legislators have considered prohibiting balanced billing altogether if the physician community did not develop a patient-friendly solution.
HB 1714 (Ware) would address emergency balanced billing; the bill would protect patients from balanced billing and ensure physicians are paid directly. In addition, the bill would pay providers a fair and reasonable amount. HB 1714 is supported by the entire physician community; MSV President, Dr. Richard Szucs, and Dr. Tricia Anest, MSV and VACEP member, testified in support of the bill. However, there are other bills supported by the insurance industry. If you have a relationship with a member of the House Commerce and Labor Committee, please reach out to our GA team.
Stay tuned for email legislative alerts that will have specific action steps to take to support these bills.
Prior Authorization and Step Therapy
MSV supports SB 1607 (Dunnavant), a bill that would reform and streamline prior authorization for medications. The bill would also ensure payment for pre-approved surgeries and invasive procedures; during an approved procedure, if a physician provided appropriate additional medical care they would be reimbursed without requiring an additional authorization. This bill has been sent to the Senate Commerce and Labor Committee, but has not yet been scheduled for a hearing.
HB 2126 (Davis) is a step therapy reform bill that would create medically necessary exemptions to step therapy protocols and create an expedient exemption process for patients already on an effective treatment. This bill has not yet been heard, however, VCU first year medical students were at the Capitol advocating with several legislators this week on the issue.
Physician Assistants
HB 1952 (Campbell) and SB 1209 (Peake) were heard in the House Health, Welfare, and Institutions subcommittee and Education and Health Committee this week, respectively. Both bills would make administrative updates to Physician Assistant practice, bringing Virginia’s code in line with current Board of Medicine regulations. MSV has been working closely with our Physician Assistant members as well as the Virginia Academy of Physician Assistants to support this effort.
Certificate of Public Need (COPN)
Bills have been filed for COPN ranging from complete repeal, to individual exemptions, to minor amendments to existing laws. SB 1526 (Sturtevant) would expedite the COPN process to permit additional psychiatric beds and facilities in the case of an emergency or crisis situation. SB 1614 (McDougle) would create a permitting process for endoscopic, urologic, and ophthalmic outpatient/ambulatory surgery centers. MSV maintains its position of modernizing the COPN process to support comprehensive reform that increases access to needed services, while still ensuring safety, quality, and the provision of charitable care.
House of Medicine Wins
HB 1767 (Jones), SB 1543 (Surovell); Parents of Deceased Added as First Class Beneficiaries
This bill was favorably amended but would have expanded the list of beneficiaries who could recover in a wrongful death action; the bill proposed including the parents of the decedent if the decedent was providing them any support or services. This change would apply to all wrongful death actions, including medical malpractice cases.
SB 1518 (Carrico) – Non-opioid pharmacological therapy and non-pharmacological therapy; health insurance coverage.
This bill would have directed the Boards of Medicine and Dentistry to develop regulations on opioid prescribing that already currently exist. The MSV GA team spoke with the patron, explaining the current regulations, and he withdrew the bill.
Keeping You Up-to-Date
If you are an MSV member, each legislative update is sent every Friday to your inbox. Keep your email preferences up to date by logging in to your member profile. If you are not an MSV member, you can join today to start receiving timely communications to your inbox among many other member benefits. MSV is fighting for you to ensure physicians are the table when important decisions are being made that impact Virginia medicine and health care.
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Register Now for MSV Lobby Days
We are excited to add another Lobby Day to our 2019 schedule. In addition to January 30, there will also be a Lobby Day held on February 6. We encourage you to register before January 16 so that we can schedule appointments for you.
Register for January 30 Lobby Day
Register for February 6 Lobby Day
Key Issues
MSV is hard at work reviewing the bills that will impact medicine and patient care in Virginia. This week, we are sharing highlights of key issues that are before the legislature. In next week’s issue, expect specific bill descriptions and their progress.
Surprise/Balance Billing
Multiple bills have been filed and MSV, along with other specialty groups, are working to favorably amend the bills to hold patients harmless, while still protecting a physician’s ability to negotiate with payers to receive fair and timely reimbursement. This week, the Richmond Times-Dispatch published an op-ed written by Dr. Mark Monahan, MSV member and Richmond Academy of Medicine Board of Trustees President, about balance billing.
Prior Authorization and Step Therapy
MSV is building on the work from 2015 to reform the prior authorization process. As a priority issue this session, MSV seeks to ensure patients’ medical care is determined by their physicians, not the insurance companies. Further, MSV is working to guarantee that if a service or procedure is pre-authorized by a health plan, the health plan cannot deny payment for that service.
MSV is also supporting step therapy reforms; it is critical that patients living with chronic health conditions have timely access to the life-saving treatments they need.
Medicaid Reimbursement
Del. Scott Garrett and Sen. Emmett Hanger are submitting budget amendments that would increase Medicaid reimbursement rates for physicians currently reimbursed under 75 percent of Medicare. Stay tuned for an alert from MSV as soon as the amendment is filed. The committees must hear from you to include the amendments in the final budget proposals.
Physician Assistants
A bill has been filed to make an administrative update to Physician Assistant practice, bringing the Code in line with current Board of Medicine regulations. MSV has been working closely with our Physician Assistant members as well as the Virginia Academy of Physician Assistants to support this effort.
Certificate of Public Need (COPN)
Bills have been filed for COPN ranging from complete repeal, to individual exemptions, to minor amendments to existing laws. MSV maintains its position of modernizing the COPN process to support comprehensive reform that increases access to needed services, while still ensuring safety, quality, and the provision of charitable care. Read the informative story from The Virginia Mercury shared this week about the history of COPN in Virginia.
On September 8, 2018, I declared that a state of emergency exists in the Commonwealth of Virginia based on the need to prepare and coordinate our response for potential impacts from Hurricane Florence. National Weather Service forecasts indicate Hurricane Florence could produce damaging winds, periods of heavy rainfall, power outages, and flooding in the Commonwealth. These conditions have the potential to impact life safety and create significant transportation issues throughout Virginia.
State action is required to protect the health and general welfare of Virginia residents. The anticipated effects of this situation constitute a disaster wherein human life and public and private property are, or are likely to be, imperiled, as described in § 44-146.16 of the Code of Virginia.
Therefore, by virtue of the authority vested in me by § 44-146.17 of the Code of Virginia, as Governor and as Director of Emergency Management, and by virtue of the authority vested in me by Article V, Section 7 of the Constitution of Virginia and by § 44-75.1 of the Code of Virginia, as Commander-in-Chief of the armed forces of the Commonwealth, and subject always to my continuing and ultimate authority and responsibility to act in such matters, I hereby proclaim a state of emergency exists. Accordingly, I direct state and local governments to render appropriate assistance to prepare for the impacts of Hurricane Florence, to alleviate any conditions resulting from the situation, and to implement recovery and mitigation operations and activities so as to return impacted areas to pre-event conditions as much as possible.
Read the full executive order including measures A through W ordered by the Governor.
Sections J, M, S, T, U relate directly to physicians and health care providers, specifically regarding the rendering of aid, emergency services, or health care. They are below:
J. Provision of appropriate assistance, including temporary assignments of non-essential state employees to the Adjunct Emergency Workforce, be rendered by state agencies to respond to this situation.
M. Authorization for the heads of executive branch agencies, with the concurrence of their Cabinet Secretary, to act, when appropriate, on behalf of their regulatory boards to waive any state requirement or regulation where the federal government has waived the corresponding federal or state regulation based on the impact of events related to this situation.
S. During this declared emergency, any person who holds a license, certificate, or other permit issued by any state or political subdivision thereof, evidencing the meeting of qualifications for professional, mechanical, or other skills, the person, without compensation other than reimbursement for actual and necessary expenses, may render aid involving that skill in the Commonwealth during this emergency. Such person shall not be liable for negligently causing the death of, or injury to, any person or for the loss of, or damage to, the property of any person resulting from such service as set forth in § 44-146.23(C) of the Code of Virginia. Additionally, members and personnel of volunteer, professional, auxiliary, and reserve groups identified and tasked by the State Coordinator of Emergency Management for specific disaster-related mission assignments, as representatives of the Commonwealth engaged in emergency services activities within the meaning of the immunity provisions of § 44-146.23(A) of the Code of Virginia, shall not be liable for the death of, or any injury to, persons or damage to property as a result of such activities, as provided in § 44-146.23(A) of the Code of Virginia.
T. Designation of physicians, nurses, and other licensed and non-licensed health care providers and other individuals as well as hospitals, nursing facilities, and other licensed and non-licensed health care organizations, political subdivisions and other private entities by state agencies, including the Departments of Health, Behavioral Health and Developmental Services, Social Services, Emergency Management, Transportation, State Police, Motor Vehicles, as representatives of the Commonwealth engaged in emergency services activities, at sites designated by the Commonwealth, within the meaning of the immunity provisions of § 44-146.23(A) of the Code of Virginia, in the performance of their disaster-related mission assignments.
U. A license issued to a health care practitioner by another state, and in good standing with such state, shall be deemed to be an active license issued by the Commonwealth to provide health care or professional services as a health care practitioner of the same type for which such license is issued in another state, provided such health care practitioner is engaged by a hospital, licensed nursing facility, or dialysis facility in the Commonwealth for the purpose of assisting that facility with public health and medical disaster response operations. Hospitals, licensed nursing facilities, and dialysis facilities must submit to 6 the applicable licensing authority each out-of-state health care practitioner’s name, license type, state of license, and license identification number within a reasonable time of such healthcare practitioner arriving at the applicable health care facility in the Commonwealth.
