Below, you will find updates on Surprise Balance Billing, Scope of Practice, COPN, Public Health, Medicaid Reimbursement, and more.

Surprise Balance Billing

The 2020 legislative session has seen numerous potential balance billing laws introduced in both the Senate and the House. Senator Favola introduced SB 172, which at its introduction, used language from MSV’s emergency balance billing legislation from last year. The bill has received multiple amendments at the request of stakeholders, these amendments include:

  • Inclusion of emergency and non-emergency out-of-network claims
  • Removal of language using a regional commercial average.
  • Establishment of a fair dispute resolution process for providers and insurers.
    • Doctors and hospitals will only request arbitration if they think the “usual and customary payment” is unreasonable and the normal dispute process breaks down.
  • Language allowing the Bureau of Insurance to establish the rules for an expedited arbitration process.
    • This is NOT “baseball style” arbitration.

This legislation successfully passed the Senate floor and is now before the House of Delegates. Please continue to lobby your Delegate to support this pivotal piece of legislation!

In another bit of good news, the insurance backed legislation SB 767 (Barker) was defeated in the Senate Finance and Appropriations committee.

Scope of Practice

Scope of practice has continued to be a focus of legislators during the 2020 General Assembly. Numerous pieces of legislation were introduced which sought to expand the scope of practice for different professions. Two major scope issues emerged: licensing naturopathic “doctors,” and pharmacist diagnostic and prescriptive authority.

HB 1040 (Del. Rasoul) and SB 858 (Petersen) attempted to license naturopaths, allowing them to prescribe medications, perform minor surgical procedures, and order and perform physical exams and lab tests. SB 858 was referred to the Department of Health Professions (DHP) for a workforce review study. This study will evaluate whether naturopaths meet seven criteria for potential licensure. If all seven criteria are met, the bill would likely be brought back to next year’s GA session. HB 1040 also failed to advance very far. The House HWI committee voted to carry the legislation over until 2021 after the conclusion of the DHP study requested by the Senate. This was a MAJOR victory for the house of medicine and MSV would like to thank all of those who sent emails, made phone calls, and talked to legislators on this issue!

The second major scope battle being undertaken by the physician community is the expansion of pharmacists’ scope of practice. When introduced both HB 1506 (Del. Sickles) and SB 1026 (Sen. Dunnavant) allowed pharmacists to use CLIA-waived tests to diagnose and administer prescription medications for the flu, strep, and other conditions.

MSV initially opposed both bills and was able to successfully work with Del. Sickles to amend the legislation to more closely reflect the recommendations of the Joint Health Care Commission. Under the House bill, the discussion of pharmacists’ scope of practice will now go to a workgroup made up of members from the Board of Pharmacy, Board of Medicine, MSV, the Virginia Pharmacists Association, and the Department of Health. This exemplifies the importance of members voicing their concerns and reaching out to members of the General Assembly.

MSV continued to oppose Senator Dunnavant’s SB 1026. This legislation successfully passed through the Senate and still allowed pharmacists to use CLIA-waived tests to diagnose and administer prescription medications for the flu, strep, and other conditions. This legislation was laid on the table in the House Health, Welfare and Institutions committee.

Virginia Mental Health Access Program

Please continue to encourage legislators to support the Virginia Mental Health Access Program (VMAP). The Governor included in his budget a $4.22 million increase for VMAP. This increase would fully-fund the program. VMAP works to expand access to mental health care for children and adolescents by training primary health care providers in mental health treatment, connecting families with care navigation resources, and establishing telehealth services with child psychiatrists. This funding for VMAP would help establish 5 regional hubs of psychiatrists, psychologists, and care navigators that would support approximately 400,000 children.

Public Health

HB 115 (Hope) and SB 120 (Barker), MSV’s physician wellness legislation, successfully passed their respective chambers unanimously. The bill have now ‘crossed over’ and will be reviewed once again by the House and Senate.

Delegate Hope’s HB 1090 aligns the Board of Health’s Regulations for the Immunization of School Children to be consistent with the immunization schedule developed and published by the CDC, the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians. This bill passed out of the House and has successfully reported out of the Senate Finance and Appropriations committee. You all represent the advocacy leaders of MSV and we ask that you voice your support to your Senator.

Numerous firearm safety measures have passed their respective chambers, including the two universal background check bills, SB 70 (Locke) and HB 2 (Plum).


All legislation introduced on Maintenance of Certification has been stricken, or otherwise failed to pass either the House or Senate. 

The legislation brought forward would have legislated physician education – which does not align with MSV policy. President Dr. Cliff Deal III has called a task force be put together at the close of session for the House of Medicine to work on solutions to reform MOC.

Read more about MSV’s work on MOC on our website.


All patient and physician-backed COPN legislation was stricken or otherwise failed to pass the House or Senate. While there are COPN bills still being considered—HB 879 (Sickles), SB 279 (Barker), and SB 1081 (Sutterlein)—MSV has no position on any of these bills and will monitor them as they progress.

Read more about MSV’s work on COPN on our website.