Legislative Update – February 14, 2020

General Assembly session reached crossover on Tuesday. “Crossover” is the midpoint of the session, where bills passed by the House are considered by the Senate, and vice versa.

Scope of Practice


Thanks to the extensive outreach by the medical community, Del. Sickles amended HB 1506 to study the more controversial provisions regarding pharmacists scope of practice–including using CLIA waived tests to treat flu and strep. This will be studied by the Board of Pharmacy, Department of Health, and Board of Medicine, with MSV as a named stakeholder.

Unfortunately, the Senate did not make similar changes to their bill, and passed Sen. Dunnavant’s SB 1026 earlier this week. This legislation would still allow pharmacists to diagnose and treat a number of conditions, including flu and strep. MSV remains opposed to this legislation. With crossover occurring on Tuesday night, this bill has now been sent over to the House.

These bills are likely to end up in conference where we will need your help. In the interim, please share your experiences about the complexities of diagnosing and treating patients for seemingly “simple” illnesses.

We need our physician members to share their experiences with the complexities of diagnosing and treating patients for seemingly “simple” illnesses.

Share your Experience

Surprise Balance Billing

The Senate floor took up the balance billing battle on Tuesday and thanks to many calls and messages to Senators throughout the hearing process, Senator Favola’s SB 172 successfully passed by a vote of 36-4. In another bit of good news, the insurance industry’s bill SB 767 (Barker) was defeated on Monday in the Senate Finance and Appropriations committee.

SB 172 (Favola) was originally MSV’s balance billing legislation from last year. Since being introduced, the bill has been amended to satisfy the input of multiple stakeholders. The following changes have been made to SB 172:

  • The bill has been modified to include emergency and out-of-network care provided at an in-network facility.
  • The language about using a regional commercial average has been removed.
  • The bill now establishes 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.
  • The Bureau of Insurance will establish the rules for an expedited arbitration process that is different than “baseball style” arbitration.

The fight is not over, and we must now lobby the House of Delegates to ensure that this legislation successfully passes.

Public Health


HB 1090 (Hope) passed the House by a vote of 53 to 44. The bill would align the Board of Health’s Regulations for the Immunization of School Children to be consistent with the Immunization Schedule developed and published by the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians.

The bill will now be heard by the Senate Committee on Education and Health.

Only constituents of committee members will be able to send a message using the button link below.

Send a message in support of HB 1090


SB 993 (Locke) would allow non-clinicians to serve as either the State Health Commissioner and/or director of the local health department. Currently, Virginia requires the State Health Commissioner and local health directors to be a licensed Virginia physician.

The State Health Commissioner and local health directors have a myriad of responsibilities for keeping Virginians safe and healthy. Notably, these physicians are responsible for developing and responding to emerging public health epidemics such as Ebola, Zika, and Coronavirus. These emerging critical health issues require clinical expertise and decision making to ensure the appropriate response protocols are developed.

MSV is opposed to the legislation and will be working with the patron and Committee members to ensure Virginia’s public health system remains strong.

Budget Season Update

Budget amendment season is now upon us. MSV is actively supporting several budget amendments including:


Budget Amendments 313 #21h (Carr) and 313 #29s (Dunnavant) would increase Medicaid reimbursement rates for primary care and specialty physician services to 88 percent of the Medicare rate – the same rate as Virginia’s hospitals. Medicaid’s current low reimbursement rates make it unsustainable for some medical practices to employ, support, and retain the team needed to care for Medicaid patients. The budget amendments will make it more feasible for physicians to participate in Medicaid and help expand access for Medicaid patients.


Budget Amendment 295 #2h (Hurst) will revitalize a physician loan repayment program that has not been funded in 10 years. This program seeks to help alleviate student debt accrued during college and medical school for physicians who are willing to practice in an underserved area for a minimum of 2 years. Participating physicians in this program will receive a maximum of $200,000 over four years. The budget amendment would allocate $4 million/year to fund 20 positions.


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. The Governor included in his budget a $4.22 million increase for VMAP which would support five regional hubs. The five hubs would support approximately 400,000 children in Virginia with a team of a psychiatrist, psychologist, and care navigator at each hub.