Legislative Update – February 15, 2019

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.

Medicaid Reimbursement Rates


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.

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Surprise/Balance Billing

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.

House of Medicine Wins

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!

Prior Authorization and Step Therapy

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.

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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.

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Physician Assistants

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!

Health Insurance

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.

Public Health

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.