Welcome to the 2019 General Assembly Session

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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.

Governor Ralph Northam, MD Declares a State of Emergency for Virginia

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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.

A Legislative Update from MSV

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Below is the latest Legislative Update from MSV. Click here to view the continually-updated 2017 Legislative Agenda.

White Coats on Call

On Tuesday, MSV kicked off the first of four White Coats on Call Lobby days with 89 participants including radiologists, anesthesiologists, emergency room physicians, as well as groups from Arlington and Danville.  The group heard from Lieutenant Governor Ralph Northam, M.D., who energized attendees before they headed over to the General Assembly building.  Members visited legislators on every floor of the building, lobbying on issues like COPN reform, opioid misuse, licensure parity, and step therapy.  A group of medical students had the honor of being introduced on the Senate floor by Sen. Siobhan Dunnavant, MD (R-Henrico), who welcomed all White Coats on Call attendees and thanked MSV for its activism. 

Legislation Updates – Bills supported by MSV

  • Del. John O’Bannon, MD’s (R-Henrico) COPN reform bill, HB 2337, was unanimously passed by a subcommittee of the House Health, Welfare, and Institutions committee and will now be heard by the full committee on Tues., Jan. 31.  His bill replaces the current COPN system with a permitting process that mirrors MSV policy, but only in areas that meet a certain population density threshold.
  • Sen. Siobhan Dunnavant, MD’s (R-Henrico) COPN reform bill, SB 1566, was heard in the COPN subcommittee of the Senate Education and Health committee on Fri., Jan. 27.  The subcommittee did not take a vote on any legislation, but is expected to meet again next week for a vote.
  • SB 1046, carried by Sen. Bill Stanley (R-Moneta) which would create licensure parity between U.S. and international medical school graduates passed the Senate 39-0.  HB 2277, the House version carried by Del. Danny Marshall (R-Danville), was passed unanimously by the House Health, Welfare, and Institutions committee and will now move to the House floor for a vote.
  • HB 2053, Del. Steve Landes’ (R-Weyers Cave) bill to stipulate that direct primary care agreements do not constitute insurance, passed the House Commerce and Labor committee and will now move to the House floor for a vote.   
  • Unfortunately, both the House and Senate versions of bills which would’ve created an expedited override process for step therapy failed in their respective committees.

Averted Legislation

  • HB 2042, carried by Del. Kathleen Murphy (D-McLean), would have required providers to take CME specifically on suicide prevention.  The MSV lobby team was able to work with Del. Murphy, offering to provide information on our website regarding suicide prevention, which she was happy to accept.  The bill was laid on the table in subcommittee.
  • HB1424, carried by Del. Mark Cole (R-Spotsylvania), would have required prescriptions to include on the label the reason the medication was prescribed. It was laid on the table in subcommittee. 

Register to take part in national meaningful use and public health surveys

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The Center for Disease Control (CDC) National Center for Health Statistics conducts national health care surveys to collect data and information used by Congress, health care services researchers and others to shape health care policy and the future of health care in the United States. 

The National Center for Health Statistics is accepting registration from eligible professionals (EPs), eligible hospitals (EHs) or Critical Access Hospitals (CAHs) of their intent to submit data to the national health care surveys as part of the Medicare and Medicaid EHR incentive programs (Meaningful Use). You may attest to either Objective 10 – Public Health and Clinical Data Registry Reporting, Measure 3 for MU Stage 2 or Objective 8 – Public Health and Clinical Data Registry Reporting, Measure 4 for MU Stage 3. 

Please click here to see the updated National Health Care Surveys Declaration of Readiness and consider registering for the National Health Care Surveys. EPs, EHs and CAHs can register their intent to submit data by emailing [email protected].