Legislative Update – February 1, 2019

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.

Key Issues 

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.

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. 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.

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Surprise/Balance Billing

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.

Public Health

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.

House of Medicine Wins

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.

Health Insurance

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.

Balance Billing

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.  

Prior Authorization and Step Therapy

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.

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Physician Assistants

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.