Legislative Update – February 21, 2020

General Assembly session is on the other side of crossover and in the home stretch. We are still focused on several important bills that need your support!

Scope of Practice

PHARMACISTS

Del. Sickles HB 1506 and Sen. Dunnavant’s SB 1026 remain in the same place as last week. The House bill awaits a Committee hearing in the Senate, and the Senate awaits a Committee hearing the House.

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. This legislation would still allow pharmacists to diagnose and treat a number of conditions, including flu and strep. MSV remains opposed to this legislation.

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

Senator Favola’s SB 172 is awaiting to be heard by the House Committee next week. While the insurance industry’s bill – SB 767 (Barker) – remains defeated, the health insurance lobby is actively working against the Favola bill.

SB 172 (Favola) is supported by MSV, the hospitals, and patients. The bill includes emergency and out-of-network care, and uses an alternative dispute resolution arbitration mechanism to remove the patient from surprise billing scenarios. 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.

We are still working to have the Senate bill be amended and adopted by the House patrons. Those conversations are ongoing between Senator Favola, Delegates Sickles, and Delegate Torian. The fight is not over, and we must now lobby the House of Delegates to ensure that this legislation successfully passes.

Public Health

VACCINES

HB 1090 (Hope) passed Senate Education and Health yesterday and will now move to Senate Finance. 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 move to Senate Finance. It is important that we continue to support this bill due to the fierce opposition by the anti-vax community. In the Roanoke Times this week, Dr. John W. Epling details why it’s so important that Virginia strengthen vaccine requirements by passing HB 1090.

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

Support HB 1090

PUBLIC HEALTH DIRECTORS

MSV was successful in defeating SB 993 from Senator Locke this week. 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.

Thank you to Dr. Cyn Romero who came to testify on the bill and explain the responsibilities of a local health director, including prescriptive authority requirements. The bill was continued to 2021.

Physician Well-Being

PROFESSIONAL WELL-BEING PROGRAM

HB 115 (Hope) has successfully passed from both chambers. SB 120 (Barker) was passed off the floor this week with a small technical amendment. The bills will now be sent to the Governor for signature. The intent of these bills is to create a “safe haven” for physicians, outside of their employers, in order to get the support they need. This added security of confidentiality removes the barriers of stigma from colleagues or fear of losing their job, or worse, their license.


Budget Update

The budgets in the Senate and the House were presented in the respective Finance Committees this past Sunday. Unfortunately, our amendments for the Physician Loan Repayment program and increasing Medicaid reimbursements failed to make either budget. Most of the health care dollars in the budget went to the state-based exchange and mental health care. These were priorities for the Democrats this year.

VIRGINIA MENTAL HEALTH ACCESS PROGRAM (VMAP)

The Virginia Mental Health Access Program (VMAP) increased funding of $4.22 million was kept in both budgets. 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 new budget will help build five regional hubs that would support approximately 400,000 children in Virginia with a team of a psychiatrist, psychologist, and care navigator at each hub.

MEDICAID RATES

There were smaller investments on Medicaid rates to bring anesthesia up to the 70 percent rate we achieved last session.