1999 Virginia House Legislation

Updates will be available each Monday morning throughout the 1999 General Assembly Session.

Enacted Legislation

Terminated Legislation

Enacted Legislation

HB 699 - Passed House (92-Y 5-N) with Committee Substitute; Passed Senate (39-Y 0-N); approved by GovernorPatron: Vincent F. Callahan, Jr.
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Accident and sickness insurance; coverage for hospice care. Requires health insurers, health maintenance organizations and corporations providing accident and sickness subscription contracts to provide coverage for hospice care. "Hospice care" means a coordinated program of home and inpatient care provided directly or under the direction of a licensed hospice and includes palliative and supportive physical, psychological, psychosocial and other health services to individuals with a terminal illness utilizing a medically directed interdisciplinary team. "Terminal illness" means a condition in an individual that has been diagnosed as terminal by a licensed physician, whose medical prognosis is death within six months, and who elect to receive palliative rather than curative care. The bill stipulates that documentation requirements for hospice coverage must be no greater than those required for the same services under Medicare. This bill does not prevent insurers, corporations, or health maintenance organizations from offering or providing coverage for hospice services where it cannot be demonstrated that the illness is terminal or that the individual's life expectancy is longer than six months. The provisions of this bill do not apply to short-term travel, accident only short-term nonrenewable policies of not more than six months duration or to Medicare supplement policies.

HB 871 - Passed House (73-Y 23-N 2-A) with Committee Substitute; Passed Senate (40-Y 0-N) with Floor Substitute and Amendments; Senate Substitute and Amendments agreed to by House (98-Y 0-N 1-A); approved by GovernorPatron: H. Morgan Griffith
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Health care coverage networks; any willing provider; hospitals. Requires health insurers and corporations issuing health care coverage policies and subscription contracts administered through preferred provider networks, together with health maintenance organizations (HMOs) to accept any hospital within a 75 mile radius of such hospital as a preferred or participating provider if it is willing to accept the same terms and conditions of network inclusion applicable to other hospitals accepted as network providers. The bill has a reenactment clause; its provisions will not become effective unless reenacted by the 2000 Session of the General Assembly.

HB 1274 - Passed House (99-Y 0-N) with Committee Substitute; Passed Senate (32-Y 0-N 6-A) with Committee Substitute; Senate substitute agreed to by House (97-Y 0-N); approved by GovernorPatron: William K. Barlow
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Insurance; rebates and charges in excess of premium prohibited; exceptions. Prohibits insurance agents and other insurer representatives from requesting or receiving from an insurance applicant any compensation in excess of required insurance premium payments, unless (i) the applicant consents to such additional compensation, in writing, before insurance services are rendered and (ii) a schedule of fees and documentation for services is made available to applicants and policy holders, upon request.

HB 1546 - Passed House (100-Y 0-N) with Committee Amendment; Passed Senate (40-Y 0-N); approved by GovernorPatron: Harry R. Purkey
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Income tax; deduction for long term health care insurance. Provides a deduction, from federal adjusted gross income in calculating Virginia taxable income, for long term health care insurance premiums, for taxable years beginning on and after January 1, 2000, provided the individual has not claimed a deduction for federal income tax purposes.

HB 2033 - Passed House (85-Y 15-N) with Committee Amendments; Passed Senate (39-Y 0-N) with Committee Amendments; Senate amendment agreed to by House (94-Y 6-N); approved by GovernorPatron: Brian J. Moran
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Definition of family abuse. Redefines "family abuse" to mean any act involving violence, force, threat or intimidation, rather than the current "act of violence" which causes or results in any forceful detention or physical injury or places a person in reasonable apprehension of serious bodily injury and which is committed by a person against a family or household member.

HB 2193 - Passed House (100-Y 0-N) with Committee Substitute; Passed Senate (40-Y 0-N) with Committee Substitute; Senate substitute rejected by House (7-Y 88-N); House acceded to Senate request for appointment of conferees; Senators: Stosch, Gartlan, K. G. Miller, Marye; Delegates: Hall, Tate, Cantor, Rhodes; Conference Report agreed to by House (96-Y 0-N) and Senate (40-Y 0-N); approved by GovernorPatron: John H. Tate, Jr.
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Tax credit for care provided to impaired elderly relatives. Provides a $500 tax credit to individuals or couples whose Virginia adjusted gross income does not exceed $50,000 who provide unreimbursed care to an impaired elderly relative who required assistance with one or more activities of daily living during more than half the year and is at least age 60. Includes HB 1478 (Darner), HB 1509 (Deeds) and HB 2742 (Hall).

HB 2213 - Passed House (97-Y 1-N 1-A) with Committee Substitute; Passed Senate (39-Y 0-N) with Committee Amendments; Senate amendments agreed to by House (98-Y 0-N); approved by GovernorPatron: Harry J. Parrish
Alzheimer's Association position:
Summary as Passed House:
Health insurance; fair business practices. Establishes fair business practices standards applicable to the claim reimbursement practices of health insurance carriers, health services plans and HMOs (referred to as "carriers"). The section requires carriers to (i) pay claims within 40 days of claim receipt, unless the claim is not a clean claim, is disputed in good faith, or there is otherwise no obligation to pay, (ii) contact health care providers within 30 days of receiving reimbursement claims if they desire further claim information or documentation, and (iii) establish reasonable policies giving providers notice of and detailed information concerning carriers' required administrative claims processing procedures. The legislation also prohibits retroactive claim denial unless claims are fraudulent, previously paid, or retroactively reviewed within the lesser of 12 months or a period equal to the number of days in which claims must be submitted after a health care service is provided. On and after July 1, 2000, a carrier must notify a provider at least 30 days in advance of any retroactive denial of a claim. The bill also requires that carriers' provider contracts (and any subsequent amendments) disclose carrier reimbursement fee schedules and policies. The legislation establishes private rights of action for providers who suffer actual damages resulting from carrier violations of the bill's provisions. Providers are entitled to recover treble damages for any willful violations. The Virginia State Corporation Commission is given regulatory oversight cncerning the bill's provisions.

HB 2228 - Passed House (100-Y 0-N); Passed Senate (40-Y 0-N) with Committee Amendment; Senate amendment agreed to by House (99-Y 0-N); approved by GovernorPatron: Phillip A. Hamilton
Alzheimer's Association position: SUPPORT
Summary:
Health regulation; nursing homes and certified nursing aides. Requires nursing homes to fully inform patients in summary form of the findings concerning the facility in federal Health Care Financing Administration surveys and inspections, if any. The bill also requires nursing aide education programs designed to prepare nurse aides for certification to be a minimum of 120 clock hours in length. The curriculum of such programs shall include, but not be limited to, communication and interpersonal skills, safety and emergency procedures, personal care skills, appropriate clinical care of the aged and disabled, skills for basic restorative services, clients' rights, legal aspects of practice as a certified nurse aide, occupational health and safety measures, culturally sensitive care, and appropriate management of conflict. The Board of Nursing shall promulgate emergency regulations to implement the nurse aide education program provisions.

HB 2283 - passed House (97-Y 0-N 1-A); Passed Senate (40-Y 0-N) with Committee Substitute; Senate substitute agreed to by House (86-Y 0-N); Governor's Amendments proposed; House concurred in Governor's recommendation (93-Y 2-N); Senate concurred in Governor's recommendation (39-Y 0-N); Governor's recommendation adopted
Patron: Harvey B. Morgan
Alzheimer's Association position: SUPPORT
Summary:
Accident and sickness insurance; guaranteed availability of individual health insurance coverage. Requires health insurance issuers to include questions on forms for individual health insurance that will enable the health insurance issuer to determine whether an applicant qualifies as an "eligible individual." "Eligible individuals" must be issued individual health insurance coverage without a preexisting conditions limitation if the coverage is issued within 63 days of termination of coverage under a prior group health insurance contract.

HB 2314 - Passed House (100-Y 0-N); Passed Senate (39-Y 0-N 1-A); approved by GovernorPatron: Thomas G. Baker, Jr.
Alzheimer's Association position:
Summary:
Health; certificate of public need. Eliminates a certificate of public need for the replacement of certain diagnostic imaging equipment, including computed tomography, positron emission tomography, and magnetic source imaging. This is a recommendation of the Joint Commission on Health Care.

HB 2341 - Passed House (100-Y 0-N) with floor amendments; Passed Senate (40-Y 0-N); approved by GovernorPatron: S. Chris Jones
Alzheimer's Association position:
Summary as Passed House:
Health professions; prescriptive authority of nurse practitioners and physician assistants. Adds authority for licensed nurse practitioners and physician assistants who have prescriptive authority to receive and dispense manufacturers' professional samples.

HB 2358 - Passed House (100-Y 0-N) with Committee Substitute; Passed Senate (40-Y 0-N) with Committee Amendments; Senate amendments agreed to by House (95-Y 0-N); approved by GovernorPatron: James F. Almand
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Income tax; accessibility features for the disabled tax credit. Provides an income tax credit to individuals who add certain features to their homes so they are accessible to the disabled, effective for taxable years beginning on and after January 1, 2000, provided none of the car tax triggers occurs prior to that date. If one or more of such triggers occurs, the bill is effective January 1 of the year following the year in which none of the triggers occurs. The amount of the credit is 25 percent of the amount spent on such features, not to exceed $500 or the individual's tax liability in the taxable year the feature is completed. The taxpayer must apply for the credit on their tax return or when filing for an extension. Tax credits granted for such proposals shall not exceed $1 million in any taxable year.

HB 2369 - Passed House (99-Y 0-N 1-A) with Committee Substitute; Reported from Senate Committee on Education and Health (15-Y 0-N) with Committee Substitute; Senate substitute rejected by House (2-Y 94-N 1-A); House acceded to Senate request for appointment of conferees; Senators: Woods, Couric, Martin; Delegates: Rust, Hamilton, DeBoer; Conference Report agreed to by House (92-Y 0-N) and Senate (40-Y 0-N); approved by GovernorPatron: John H. Rust, Jr.
Alzheimer's Association position:
Summary as Passed House:
Medical care facilities certificate of public need. Eliminates the requirement for a certificate of public need for the replacement of any equipment; requires registration with the Commissioner of Health and the appropriate health systems agency, within thirty days of becoming contractually obligated, of purchases of any medical equipment for the provision of cardiac catheterization, computed tomographic (CT) scanning, gamma knife surgery, lithotripsy, magnetic resonance imaging (MRI), magnetic source imaging (MSI), open heart surgery, positron emission tomographic (PET) scanning, radiation therapy, or other specialized service designated by the Board regulation; and revises the administrative process for obtaining a certificate.

The administrative procedures for review of applications for certificate of public need are revised to require (i) timelines for review procedures to be speedy and concise; (ii) reduction by 25 percent, upon each failure to adhere to the established timelines, of the fee maximums allowed in the present law, up to 75 percent of the fee; (iii) transmission of the application by certified mail or a delivery service, return receipt requested; (iv) the 120-day-review period to begin on the date identified in the batching process; (v) the application review by the health systems agencies to be limited to 60 days; (vi) if the health systems review is not completed within 60 days and recommendations are not submitted within ten days after the completion of the 60-day review, the Department, on the seventy-first day, to proceed as though the health systems agency has recommended project approval without conditions or revision; (vii) the establishment of a date by the Department between the 80th and the 90th days of the review period for holding an informal fact-finding conference; (viii) the informal fact-finding hearing to be on the record and not de novo; and (ix) only the applicant authority to extend established time lines. If the Commissioner does not make a decision within sixty days of the closing of the record following the informal fact-finding conference, the application will be deemed to be approved, and the certificate must be granted. Deemed approvals will be construed as the Commissioner's case decision on the application pursuant to the Administrative Process Act and will be subject to judicial review on appeal as provided in the APA. In any case when no informal fact-finding conference is held and no decision is made with 105 days of the 120-day review period, the application will be deemed to be approved, and the certificate will granted. Any person who has sought to participate in the Department's review of a deemed-to-be approved application as a person showing good cause who has not received a final determination from the Commissioner concerning the good-cause petition will be deemed to be a person showing good cause for purposes of appeal of the approval of the certificate.

The Commissioner's annual report on COPN must include an analysis of the effectiveness of the application review procedures used by the health systems agencies and the Department which details the review time required during the past year for various project categories, the number of contested or opposed applications and the project categories of these contested or opposed projects, the number of deemed approvals from the health systems agencies and the Department because of their failure to comply with the timelines, any other data determined by the Commissioner to be relevant to the efficient operation of the program, and an analysis of the equipment registrations, including the type of equipment replaced and purchased and the equipment costs.

HB 2427 - Passed House (100-Y 0-N) with Committee Substitute; Passed Senate (40-Y 0-N); Governor's Amendments proposed; House concurred in Governor's recommendation (99-Y 0-N); Senate concurred in Governor's recommendation (40-Y 0-N); Governor's recommendation adopted
Patron: S. Chris Jones
Alzheimer's Association position:
Summary as Passed House:
Patient health records. Clarifies that no person receiving patient records from the patient or a provider can redisclose or otherwise reveal the records of the patient, beyond the purpose for which the disclosure was made, without first obtaining the patient's specific consent to the redisclosure. This redisclosure prohibition does not prevent (i) any provider who receives records from another provider from making subsequent disclosures as permitted by the law or (ii) any provider from furnishing records and aggregate or other data, from which patient-identifying information has been removed, to qualified researchers, including, but not limited to, pharmaceutical manufacturers, and their agents or contractors, for purposes of clinical, pharmaco-epidemiological, pharmaco-economic, or other health services research. "Patient-identifying prescription information" includes all prescriptions, drug orders or any other prescription information that specifically identifies an individual patient. This bill also modifies the subdivision relating to disclosure to third-party payors and their agents to note that such disclosure is "for purposes of reimbursement." There are technical amendments.

HB 2428 - Passed House (98-Y 0-N) with Committee Substitute and floor amendment; Passed Senate (40-Y 0-N) with Committee Substitute; Senate Substitute agreed to by House (100-Y 0-N); Governor's Amendments proposed; House concurred in Governor's recommendation (99-Y 0-N); Senate concurred in Governor's recommendation (40-Y 0-N); Governor's recommendation adopted
Patron: S. Chris Jones
Alzheimer's Association position:
Summary as Passed House:
Health professions; pharmacy. Provides authority for pharmacists to enter into collaborative agreements with practitioners of medicine, osteopathy, or podiatry for the purpose of improving patient outcomes.

HB 2439 - Passed House (100-Y 0-N) with Committee Amendments; Passed Senate (39-Y 0-N); approved by GovernorPatron: John H. Tate, Jr.
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Adult protective services. Clarifies that adult protective services shall be provided to persons who are found to be abused, neglected or exploited and who meet one of the following criteria: (i) the person is 60 years of age or older or (ii) the person by reason of impaired health, or physical or mental disability, cannot take care of himself or his affairs. The bill also requires mandated reporters of adult abuse, neglect and exploitation who maintain a record on a person who is the subject of such a report to cooperate with the investigating adult protective services worker and make available information, records or reports which are relevant to the investigation to the extent permitted by state and federal law.

HB 2539 - Passed House (100-Y 0-N) with Committee Substitute; Passed Senate (40-Y 0-N); approved by GovernorPatron: Whittington W. Clement
Alzheimer's Association position:
Summary:
Professional corporations; licensed nurse practitioners. Allows nurse practitioners to organize professional corporations.

HB 2632 Passed House (69-Y 30-N) with Amendments; Passed Senate (39-Y 0-N) with Committee Substitute; Senate substitute agreed to by House (84-Y 7-N); Governor's Amendments proposed; House concurred in Governor's recommendation (99-Y 0-N); Senate concurred in Governor's recommendation (40-Y 0-N); Governor's recommendation adopted
Patron: L. Karen Darner
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Department for the Aging; duties; exemption from the Public Procurement Act. Gives the Department for the Aging the additional duty to contract with the Virginia Association of Area Agencies on Aging for the administration of elder rights programs under the federal Older Americans Act (Public Law 89-73), including the long-term care ombudsman program, insurance counseling and assistance, legal assistance development and elder abuse prevention, and to create an elder information/elder rights center. The bill also allows the Department for the Aging to enter into contracts with designated area agencies on aging or their collective representatives without competitive sealed bidding or competitive negotiation (an exemption to the Public Procurement Act) for the administration of elder rights programs. The bill contains technical amendments.

HB 2708 - Passed House (100-Y 0-N); Passed Senate (40-Y 0-N) with Floor Substitute; Senate substitute agreed to by House (88-Y 1-N); approved by GovernorPatron: Eric I. Cantor
Alzheimer's Association position:
Summary:
Medical savings accounts. Authorized financial institutions within the Commonwealth of Virginia to establish medical savings accounts in accordance with federal law.

HB 2751 - Passed House (100-Y 0-N); Passed Senate (40-Y 0-N); approved by GovernorPatron: Jay W. DeBoer
Alzheimer's Association position: SUPPORT
Summary:
Health; data reporting. Extends the sunset provision for the health care data reporting requirements from July 1, 1999, to July 1, 2003. This is a recommendation of the Joint Commission on Health Care.

HJ 527 - Passed House (100-Y 0-N); Agreed to by Senate by voice vote
Patron: Harry J. Parrish
Alzheimer's Association position: SUPPORT
Summary:
Nursing home and adult care residence staffing guidelines. Directs the Joint Commission on Health Care to review staffing guidelines for nursing homes and facilities and adult care residences to determine whether staffing requirements currently in effect in the Commonwealth adequately protect the health, safety and welfare of nursing home and facility and adult care residence residents. Such review shall also include the adequacy of the enforcement of such staffing guidelines, and a recommendation for enhanced staffing guidelines based on objective data resulting from the study.

HJ 552 - Passed House (99-Y 0-N) with Committee Substitute; Agreed to by Senate with Committee Substitute by voice vote; Senate substitute agreed to by House (88-Y 0-N)
Patron: Phillip A. Hamilton
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Memorializing Congress; ERISA regulation of employer-based health plans. Memorializes Congress to amend the Employee Retirement Income Security Act (ERISA) to grant authority to the several states to regulate self-funded, employer-based health plans in order to provide greater consumer protection and effect health care reforms.

HJ 555 - Passed House (100-Y 0-N) with Committee Amendments; Agreed to by Senate by voice vote
Patron: Linda T. Puller
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Study; Medigap and Medicare managed care. Directs the Joint Commission on Health Care to study Medigap and Medicare managed care programs available in Virginia. The Commission shall examine insurance options for Medicare beneficiaries in Virginia, including (i) the availability of Medicare managed care products, (ii) the availability of Medigap policies for medicare beneficiaries who are not yet 65, and (iii) such other issues as the Commission may seem appropriate.

HJ 603 - Passed House (98-Y 2-N); Agreed to by Senate by voice vote
Patron: Robert H. Brink
Alzheimer's Association position: SUPPORT
Summary:
Study; advance directives. Requests the Joint Commission on Health Care to study the use of advance directives, or living wills, in the Commonwealth.

HJ 682 - Passed House (100-Y 0-N) with Committee Substitute; Agreed to by Senate by voice vote
Patron: Robert H. Brink
Alzheimer's Association position: SUPPORT
Summary:
Study; healthcare work-force data. Requests the Joint Commission on Health Care to examine the need to collect work-force data on nurse practitioners, clinical nurse specialists, registered nurses, licensed practical nurses, and certified nurse aides similar to the action taken in the 1998 Session for physicians.

HJ 689 - Passed House (96-Y 0-N); Agreed to by Senate by voice vote
Patron: Glenn R. Croshaw
Alzheimer's Association position: SUPPORT
Summary:
Study; efficacy of providing additional protections for vulnerable adults. Requests the Joint Commission on Health Care to study the efficacy of providing additional protections for vulnerable adults. This resolution notes that the vulnerable adult population is growing, resulting in greater need for long-term care and the response of the free enterprise system to this need. Although the Commonwealth has laws relating to undue influence in the context of various wills and trusts, adult protective services, criminal records checks of persons who work in certain health care facilities, and regulation of health professionals and facilities, additional mechanisms may be needed to protect vulnerable adults in the information/technology age. The Joint Commission is directed to: (i) review the settings and delivery of care to vulnerable adults in Virginia; (ii) enlist the input of the agencies providing services to vulnerable adults and those agencies licensing or otherwise regulating facilities and individuals providing care; (iii) review other states' laws and regulations concerning personal care services, home health care, hospice, and personal attendants; (iv) seek advice from Virginia's vulnerable adults and their families; (v) evaluate any administrative or court cases which may be reviewed without breach of confidentiality; and (vi) review such reports and academic studies of the issues as may be available.

HJ 743 - Passed House (96-Y 0-N); Agreed to by Senate by voice vote
Patron: James F. Almand
Alzheimer's Association position: SUPPORT
Summary:
Department of Housing and Community Development; affordable assisted living options for seniors. Requests the Department of Housing and Community Development, with assistance from certain other state agencies, to foster the development of affordable assisted living options for seniors in the Commonwealth through training, education, and information.

HJ 749 - Passed House (96-Y 0-N); Agreed to by Senate by voice vote
Patron: Alan A. Diamonstein
Alzheimer's Association position:
Summary:
Study; VHDA; Assisted Living Loan Program. Requests the Virginia Housing Development Authority to analyze its Assisted Living Loan Program with the goal of increasing loan production in such program.

HJ 750 - Passed House (96-Y 0-N); Agreed to by Senate by voice vote
Patron: Alan A. Diamonstein
Alzheimer's Association position:
Summary:
Study; Department of Housing and Community Development; affordable assisted living options. Requests the Department of Housing and Community Development to review national model building and safety codes to identify any such appropriate category for health and safety features, in addition to I-1 and I-2, as may foster development of affordable assisted living options in the Commonwealth.

HJ 751 - Passed House (96-Y 0-N); Agreed to by Senate with Committee Substitute by voice vote; Senate substitute agreed to by House (90-Y 0-N)
Patron: Alan A. Diamonstein
Alzheimer's Association position:
Summary:
Board of Social Services; adult care residences. Requests the Board of Social Services to consider addressing the issue of flexibility in regulations to meet changing consumer needs as the Board initiates its regular three-year review of the regulations of adult care residences.

Terminated Legislation

HB 2192 - Passed House (99-Y 0-N 1-A) with Committee Substitute; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: John H. Tate, Jr.
Alzheimer's Association position:
Summary as Passed House:
Health insurance; assignment of benefits. Prohibits (i) insurers issuing individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, (ii) corporations providing individual or group accident and sickness subscription contracts, and (iii) dental services plan offering or administering prepaid dental services from refusing to accept or make reimbursement pursuant to an assignment of benefits made to a dentist or oral surgeon by an insured, subscriber or plan enrollee. An "assignment of benefits" means the transfer of dental care coverage reimbursement benefits or other rights under an insurance policy, subscription contract or dental services plan by an insured, subscriber or plan enrollee. Such insured, subscriber or enrollee must notify the insured, subscriber or enrollee in writing of the assignment.

HB 1478 - Incorporated in other legislation (HB2193-Tate)
Patron: L. Karen Darner
Alzheimer's Association position: SUPPORT
Summary:
Income tax; tax credit for caregivers. Provides a $500 tax credit to taxpayers with adjusted gross incomes between $5,000 and $50,000, inclusive, who provide unreimbursed care to a physically or mentally impaired relative who required assistance with two or more activities of daily living during more than half the year. The credit will be available for taxable years beginning on and after January 1, 2000.

HB 1509 - Incorporated in other legislation (HB2193-Tate)
Patron: R. Creigh Deeds
Alzheimer's Association position: SUPPORT
Summary:
Income tax; tax credit for caregivers. Provides a $500 tax credit to taxpayers with Virginia adjusted gross income between $5,000 and $50,000 who provide unreimbursed care to a physically or mentally impaired relative who required assistance with two or more activities of daily living during more than half the year. The credit will be available for taxable years beginning on and after January 1, 2000.

HB 1920 - Reported from Corporations, Insurance and Banking (26-Y 0-N); Referred to Committee for Courts of Justice; No action taken by Courts of Justice
Patron: Clarence E. Phillips
Alzheimer's Association position: OPPOSE
Summary:
Guardianship or conservatorship. Deletes the provisions in the evaluation report for guardianship or conservatorship detailing the proposed ward's incapacity, the dates of evaluation and evaluator's credentials and, instead, requires the evaluator's opinion as to whether the proposed ward has the ability to care for himself or his estate.

HB 2117 - Passed by indefinitely in Finance with amendment (22-Y 2-N)
Patron: William P. Robinson, Jr.
Alzheimer's Association position: SUPPORT
Summary:
Individual income tax; indexing age subtraction amounts. Requires the $6,000 and $12,000 age deduction amounts to be indexed annually based on the most recent percentage increase in the social security wage base, for taxable years beginning on and after January 1, 1999.

HB 2214 - No action taken by Finance
Patron: John J. Davies, III
Alzheimer's Association position: SUPPORT
Summary:
Income tax; deduction for long-term health care insurance. Provides a deduction, from federal adjusted gross income in calculating Virginia taxable income, for long-term health care insurance premiums, for taxable years beginning on and after January 1, 2000.

HB 2310 - No action taken by Health, Welfare and Institutions
Patron: Robert G. Marshall
Alzheimer's Association position:
Summary:
Medical care facilities certificate of public need. Requires the purchaser or the governing board of a facility that has been sold or restructured from nonprofit status to for-profit status to obtain a certificate of public need prior to assuming ownership or beginning operation as a for-profit institution. Present law requires notice to the Commissioner and the health systems agency of a sale of a facility for $600,000 or more and authorizes the Commissioner to require a certificate of public need for such purchase.

HB 2353 -Incorporated in other legislation (HB2594-Purkey)
Patron: Patron-John J. Davies III
Alzheimer's Association position: SUPPORT
Summary:
Review of adverse utilization review decisions; review of claims appeal by an independent external panel; penalty. Establishes, within the State Corporation Commission's Bureau of Insurance, a process of independent external review for individuals denied a course of treatment by their managed care health insurance plan. If the person seeking review is determined by the Bureau of Insurance (i) to have coverage by the health plan, (ii) to be seeking a treatment that appears to be covered by the plan, (iii) to have exhausted all available utilization review complaint and appeals procedures and (iv) to have provided all information necessary to begin review, an impartial appeals panel comprised of one representative from a licensee operating a managed care health insurance plan not involved in the complaint, one health care practitioner (selected by the individual who submitted the appeal from a list of three practitioners compiled by the Board of Medicine and selected by the State Corporation Commission) and the Commissioner of Insurance or his designee. Each individual seeking such review will pay a filing fee of $50, which is returned if the covered person prevails as a result of the review. Insurers writing accident and sickness insurance in Virginia will pay an assessment not to exceed 0.01 percent of the direct gross premium income during the preceding year to fund such appeals. The State Corporation Commission will also promulgate regulations implementing the provisions of this bill, including establishing provisions for expedited consideration of appeals involving emergency health care. Any managed care health insurance plan that does not comply within 10 working days after receipt of notification of a decision by the External Appeals Panel shall be subject to, in addition to other penalties currently in Title 38.2, an additional penalty of $500 per day noncompliance with the decision of the External Appeals Panel. Managed care health insurance plans are required to include information about the External Appeals Panel in their complaint procedures, as well as to provide information about this process anytime an adverse utilization review decision is communicated to a covered person. The bill's provisions become effective on July 1, 1999; however, the appeals process set forth in the bill does not take effect until the earlier of (i) 90 days following the promulgation of regulations by the State Corporation Commission or (ii) July 1, 2000.

HB 2389 - No action taken by Health, Welfare and Institutions
Patron: Robert H. Brink
Alzheimer's Association position: SUPPORT
Summary:
Health care; Office of the State Managed Care Consumer Advocate. Creates the Office of the State Managed Care Consumer Advocate. Such Office will be established by the Virginia State Corporation Commission's Commissioner of Insurance via contract with a nonprofit entity. The Office will assist health insurance consumers with (i) health plan selection (ii) individual health care coverage complaints, and (iii) other information and advocacy concerning managed health care plans. The Office will be funded through an annual assessment of up to 0.01 percent of the net direct premiums of Virginia-licensed health insurers, health service plans, and health maintenance organizations. The Office will submit an annual report of its activities to the Governor and the General Assembly. Additionally, the Office will make an annual report to the Virginia Joint Commission on Health Care concerning (i) the implementation of this managed care consumer advocacy program and (ii) the Office's coordination of its activities with other health care and information programs within Virginia.

HB 2395 - Passed House (99-Y 0-N 1-A) with Committee Substitute and floor amendment; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: William K. Barlow
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Prohibited incentives. Prohibits health insurance, health services plans, and health maintenance organization contracts from containing provisions which include an incentive or specific payment made directly, in any form, to a health care provider as an inducement to deny services that the provider or group knows to be medically necessary and appropriate that are provided with respect to a specific enrollee or group of enrollees with similar medical conditions. This bill does not prohibit the use of capitation as a method of payment, nor does it prohibit the inclusion of incentives or payments that reward providers or provider groups for providing services in a cost effective manner or that promote the quality initiative established under a managed care health insurance plan.

HB 2404 - Passed House (88-Y 10-N 1-A) with Committee Substitute and floor amendments; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: Gladys B. Keating
Alzheimer's Association position: No Position on House Substitute with Amendements (Supported HB 2404 as introduced)
Summary as Passed House:
Accident and sickness insurance; coverage for clinical trials for life-threatening diseases. Requires health insurers, health maintenance organizations and corporations providing accident and sickness subscription contracts to provide coverage for patient costs associated with clinical trials for treatment studies on cancer, including ovarian cancer. Patient costs covered include the costs of medically necessary health care services required in conjunction with the clinical trials. Costs not covered include the costs of research management or the cost of an investigational drug or device. The clinical trials must be approved by the National Cancer Institute, the Department of Veteran's Affairs, the Food and Drug Administration or the other specified organizations. Phases II, III and IV cancer trials would be covered. Coverage of Phase I trials would be on a case-by-case basis. The bill's provisions are applicable to policies, plans and contracts delivered, issued for delivery or renewed on and after July 1, 1999. They are not applicable to short-term travel, accident-only, limited or specified disease policies, or to short-term nonrenewable policies of not more than six months' duration.

HB 2419 - Reported from General Laws (26-Y 0-N); Referred to Committee on Appropriations; Passed by indefinitely in Appropriations (30-Y 0-N)
Patron: George W. Grayson
Alzheimer's Association position:
Summary:
Department of Personnel and Training (DPT); personnel policies of the Commonwealth; Family and Medical Leave Act (FMLA). Requires DPT's personnel policies to permit a state employee to substitute up to 50 percent of his accrued paid sick leave for leave taken pursuant to the FMLA. Current law, enacted in 1997, permits substitution of 33 percent of such leave. The FMLA permits eligible employees to take up to 12 work weeks of unpaid leave in a 12-month period for the birth of a child or the placement of a child for adoption or foster care, to care for an immediate family member (spouse, child, or parent) with a serious health condition, or when the employee is unable to work because of a serious health condition. Subject to conditions established by the employer, the FMLA also permits employees to substitute paid leave for unpaid FMLA leave. Under the Commonwealth's new sickness and disability program, which is optional for workers employed before January 1, 1999, and mandatory for new employees hired after that date, a participating employee will receive eight to ten days of sick leave annually (depending on his length of service) in lieu of earning five hours of sick leave per pay period under the current state benefits system. Under this bill, the maximum amount of unpaid FMLA sick leave that an employee receiving ten days of sick leave could substitute is five days. Without the bill, that same employee could substitute only 3.3 days. Employees who do not participate in the new program would be able to substitute 50 percent of their accrued paid sick leave balances earned under the current state benefits system.

HB 2449 - No action taken by Health, Welfare and Institutions
Patron: John A. Rollison III
Alzheimer's Association position:
Summary:
Adult protective services registry. Establishes the adult protective services registry, which shall contain a listing of any person employed by a facility or program licensed or funded by the Departments of Health, Social Services, or Mental Health, Mental Retardation and Substance Abuse Services who has abused, neglected or exploited a person sixty years of age and older, when that abuse, neglect or exploitation resulted in a local department of social services' determination that such person had or has need of protective services. Applicants for employment at nursing homes, adult care residences, mental health, mental retardation, and substance abuse programs and facilities are required to obtain a search of the adult protective services registry for a record of any investigation of adult abuse, neglect or exploitation undertaken on the applicant. The adult protective services registry is to be maintained by the Adult Protective Services Unit of the Department of Social Services. There is a technical amendment.

HB 2452 - Passed House (100-Y 0-N); Passed Senate (40-Y 0-N); Vetoed by Governor Gilmore; Motion to override Governor's veto rejected by House (53-Y 47-N); House sustained Governor's veto
Patron: Donald L. Williams
Alzheimer's Association position: SUPPORT
Summary:
Patient's health records. Provides that any limitation on the patient's ability to obtain his own record by reason of his treating physician placing a written statement in his record must be based on the physician's opinion that the furnishing to or review by the patient of such records would cause actual harm to the patient's physical or mental health or cause the patient to be an imminent danger to himself or others.

HB 2456 - Passed House (99-Y 0-N 1-A) with Committee Substitute and floor amendment; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: Donald L. Williams
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Health care provider panels, preauthorization. Provides that any health insurers, nonstock corporations providing health services plans, and health maintenance organizations (HMOs) requiring preauthorization before providing medical treatment must have someone available to give authorization at all times when such preauthorization is required. The bill provisions are also applicable to the state health care plan.

HB 2457 - Passed House (99-Y 0-N 1-A) with amendments; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: Donald L. Williams
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Health care provider panels; notice of benefit restrictions. Requires carriers to furnish group policyholders written notice of any new benefit restrictions at least 60 days before such restrictions become effective. Group policyholders, in turn, are required by the bill to give corresponding notice to affected enrollees at least 30 days before such restrictions become effective.

HB 2492 - Passed by indefinitely in Health, Welfare and Institutions (22-Y 0-N)
Patron: R. Creigh Deeds
Alzheimer's Association position: SUPPORT
Summary:
Prescription drugs for Medicare beneficiaries. Authorizes participating licensed pharmacies under agreements with the Board of Pharmacy to issue prescriptions to Medicare beneficiaries at a reduced price. The bill permits such pharmacies to purchase drugs under the same conditions as local health departments and dispense drugs to Medicare beneficiaries pursuant to Board of Pharmacy regulations. The bill also permits hospice programs to enter into agreements with participating licensed pharmacies to procure for and deliver discounted prescription drugs to Medicare beneficiaries.

HB 2495 - Passed by indefinitely in Courts of Justice (12-Y 12-N)
Patron: A. Donald McEachin
Alzheimer's Association position: SUPPORT
Summary:
HMO liability; health care treatment decisions. Establishes a cause of action for persons who suffer damages as a result of a health maintenance organization's failure to exercise ordinary care in making a health care treatment decision affecting such person. Persons may file claims directly with the court and are not required to follow the procedures governing the medical malpractice review panel or the utilization review process.

HB 2498 - Stricken from docket by Rules (15-Y 0-N)
Patron: Robert H. Brink
Alzheimer's Association position:
Summary:
Council on Aging; membership. Increases the number of members appointed by the House of Delegates and Senate from four to six each.

HB 2540 - Passed by indefinitely in Health, Welfare and Institutions (12-Y 10-N)
Patron: Robert G. Marshall
Alzheimer's Association position: OPPOSE
Summary:
Health care decisions; study. Revises various provisions relating to health care decision makers to prohibit the withdrawing or withholding of artificially administered nutrition and hydration if such removal or withholding would be the direct cause of death; prohibits judicial decisions to withdraw or withhold artificially administered nutrition and hydration for incompetent persons for whom there is no legally authorized person available to give consent; and defines "minimally conscious state." The bill provides that "terminal condition" does not include a "minimally conscious state"; no physician is authorized to withhold or withdraw a particular treatment on the authorization of a guardian or committee for the patient if any members of any prioritized class objects; any person in any priority class may obtain, upon request, the medical records of the patient for whom treatment is proposed to be provided, withheld or withdrawn; in any case where a petition is filed to prevent the removal of artificially administered nutrition and hydration for a patient who may be in a persistent vegetative state or a minimally conscious state, the petitioner may call experts to testify to the condition of the patient; and no judge can assess attorney's fees against any person who is a member of any priority class, regardless of order of priority, who has filed a petition for a finding that the action being contemplated is not lawfully authorized by law upon denying such petition for an injunction. Under this bill, the Secretary of Health and Human Resources must appoint and convene a task force to study the operation of the Health Care Decisions Act. The task force will consist of physicians, medical experts having experience with the management of coma patients and patients in persistent vegetative state, nurses, clergymen, family members, and other relevant parties. The task force will be charged with collecting data on the number of persons diagnosed as in a persistent vegetative state in Virginia; collecting data on the circumstances and ability to make an informed consent of the various patients having advance directives in Virginia's institutions; developing, with the assistance of any other experts, guidelines for identification of a diagnosis as being in a persistent vegetative state, including criteria relating to attempts to communicate, whether traditional or unique; developing, with the assistance of any other experts, guidelines for defining and identifying a diagnosis of being in a minimally conscious state, including criteria relating to attempts to communicate, whether traditional or unique; developing procedures to ensure that decisions to withdraw or withhold artificially administered nutrition and hydration are made in the best interests of the patient and will not be the direct cause of death; assessing the issues relating to decision makers under this act and other laws of the Commonwealth relating to persons incapable of making informed consent, including the provisions in this article concerning the appointment of agents and whether the guardian of an estate should also serve as the guardian of the person; examining and recommending rehabilitation and prevention guidelines and protocols for utilization of alternative therapies; and studying such other matters as the Secretary shall determine to be necessary to protect vulnerable patients. The task force will report annually to the Governor and the General Assembly on the issues before it.

HB 2541 - Failed to report (defeated) in Health, Welfare and Institutions (10-Y 12-N)
Patron: Robert G. Marshall
Alzheimer's Association position: OPPOSE
Summary:
Health Care Decisions Act. Deletes the authority to discontinue artificially administered nutrition and hydration as part of the health care decisions process, i.e., in an advance directive or by an agent named in an advance directive or by a person authorized to make a health care decision for a person incapable of informed consent in the absence of an advance directive. This provision adds a new section setting forth the "LOVING WILL," a document expressing an individual's intent for his body to be maintained regardless of prognosis and for artificially administered nutrition and hydration to be continued indefinitely.

HB 2542 - Passed by indefinitely in Health, Welfare and Institutions (21-Y 0-N)
Patron: Robert G. Marshall
Alzheimer's Association position: SUPPORT
Summary:
Sale or conversion of nonprofit hospitals. Requires that all acquisitions of nonprofit hospitals which are located in a county having a land area of 337 square miles with a population of more than 209,274 and less than 217,881 be approved by the Attorney General. The Department of Health is required to hold a public hearing and report to the Attorney General on the effect the acquisition will have on the community's continued access to health care, including indigent care. The entity acquiring the nonprofit hospital must disclose financial details about the transaction to the Attorney General. The Attorney General shall approve the application if appropriate steps are taken to safeguard the value of the charitable assets and the underlying details of the transaction reveal no conflict of interest. Failure to obtain approval prior to acquiring such a nonprofit hospital will prevent the issuance or renewal of an operating license.

HB 2565 - Passed House (99-Y 0-N 1-A) with Committee Substitute; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: Robert D. Orrock, Sr.
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Access to specialists. Requires each (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, (ii) corporation providing individual or group accident and sickness subscription contracts, and (iii) health maintenance organization providing a health care plan for health care services to provide access to specialists for those individuals with ongoing special conditions. Once such covered individual is referred to the specialist, the specialist may begin treating the individual in the same manner as the individual's primary care provider would otherwise be permitted, including the ability to authorize tests, procedures, referrals, and other medical services. Each insurer, corporation or health maintenance organization is required to develop procedures whereby a covered individual with an ongoing special condition may receive a standing referral to a specialist. Insurers, corporations, and health maintenance organizations may require a specialist to provide written notification to the individual's primary care physician, including a description of the services rendered.

HB 2578 - Passed House (99-Y 0-N) with Committee Substitute; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: Viola D. Baskerville
Alzheimer's Association position:
Summary as Passed House:
Prescription drug formularies. Requires any prescription drug formulary applied by any (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis; (ii) corporation providing individual or group accident and sickness subscription contracts; and (iii) health maintenance organization providing a health care plan for health care services to be developed only after consultation and approval by a pharmacy and therapeutics committee. This pharmacy and therapeutics committee will have a majority of its members who are physicians and must also include at least one licensed pharmacist. Additionally, each insurer, corporation, or health maintenance organization maintaining a prescription drug formulary must allow an enrollee to obtain, without additional cost-sharing beyond that provided for formulary prescription drugs within the covered benefits, a specific medically necessary nonformulary prescription drug if, after reasonable investigation and consultation with the prescribing physician, the formulary drug is determined to be an inappropriate therapy for the medical condition of the enrollee. The insurer, corporation, or health maintenance organization must act on such requests within 40 hours of receipt of the request.

HB 2593 - No action taken by Health, Welfare and Institutions
Patron: Harry R. Purkey
Alzheimer's Association position:
Summary:
Certain hospital conversions. Charges, in accordance with the doctrine of Parens Patria, the Attorney General with the oversight of any conversion of a not-for-profit hospital to a for-profit hospital, regardless of how such conversion is accomplished; the oversight of any ensuing charitable assets and surplus revenues; and assuring that the assets of the nonprofit hospital are protected and inured to the community benefit. This bill requires notice to the Attorney General at least six months prior to the execution of a contract for sale or the filing of the articles of incorporation as a for-profit corporation; an outside, independent expert's appraisal of the assets, fair market value and charitable assets of the not-for-profit hospital and amount of any offers for purchase; and a community impact statement. A review process for approval or disapproval of hospital conversion transactions will be established which must require public disclosure of the negotiations and terms of the transactions as follows: (i) at least one year prior to any such conversion, the public shall be notified of the contemplated purchase or restructuring, in accordance with the Attorney General's procedures, in a newspaper of general distribution and through radio and television announcements in the jurisdiction in which the hospital is located; (ii) within one month of disclosure of the contract for purchase or the filing of the articles of incorporation, and bimonthly thereafter until the conversion is approved or disapproved by the Attorney General or withdrawn by the relevant hospital board, public meetings and/or hearings shall be conducted by the Attorney General's Office, in accordance with the Attorney General's procedures; (iii) the community impact statement shall be published in a newspaper of general distribution in the jurisdiction in which the hospital is located; and (iv) all documents submitted to the Attorney General, regarding any such conversion, shall be available for inspection by the public at reasonable times and places in the jurisdiction. The Attorney General's process for approval or disapproval of hospital conversions must include (i) assessment of the independent expert's evaluation of assets and whether the seller is receiving fair market value for the assets; (ii) criteria to review the valuation and bidding process, transaction terms, documents, the process for the determination of fair market value, the names and activities of the parties to the transaction, management contracts, and all other collateral agreements relevant to the conversion; (iii) conditions to ensure the avoidance of conflicts of interest on the part of hospital board members and administrators; (iv) stipulations to ensure that the transaction terms are fair and in the community interest; (v) conditions and restrictions on the terms of such conversions which relate to the circumstances of the particular hospital and community; (vi) review of the seller's decisions and actions to ensure that such seller is acting with due diligence and without conflicts of interest and that the use of outside experts was appropriate; (vii) conflict of interest provisions which shall apply to all board members, hospital executives and staff and be designed to avoid conflicts of interest on the part of such hospital board members, hospital executives, and staff; (viii) accounting procedures to ensure that all charitable contributions, federal Hill-Burton moneys, and tax-free revenues are identified; (ix) safeguards to ensure continued assess to care for uninsured and underinsured populations within the jurisdiction, as well as those services traditionally provided to the public by the hospital, such as, but not limited to, emergency services; and (x) criteria to determine the appropriateness of any board or foundation established to oversee the use of any trust or endowment fund set up as a condition of such conversion. In developing and conducting the reviews of hospital conversions, the Attorney General may request, and shall receive upon request, full cooperation from the Commonwealth's agencies. The Attorney General will also determine and establish remedies and penalties for violations of this section to be included in his review and approval/disapproval procedures.

HB 2594 - Passed House (98-Y 0-N 1-A) with Floor Substitute and Amendment; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: Harry R. Purkey
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Review of adverse utilization review decisions; review of claims appeal by an independent external panel. Establishes, within the State Corporation Commission's Bureau of Insurance, a process of independent external review for individuals denied a course of treatment by their managed care health insurance plan. If the person seeking review is determined by the Bureau of Insurance to (i) have coverage by the health plan, (ii) be seeking a treatment that appears to be covered by the plan, (iii) have exhausted all available utilization review complaint and appeals procedures and (iv) have provided all information necessary to begin review, an impartial health entity shall review the final adverse decision to determine whether the decision is objective clinically valid, compatible with established principles of health care, and contractually appropriate. Each individual seeking such review will pay a filing fee of $50, which is nonrefundable. Insurers writing accident and sickness insurance in Virginia will pay an assessment not to exceed 0.015 percent of the direct gross premium income during the preceding year to fund such appeals process. The impartial health entity will issue a written recommendation within sixty days of the acceptance of the appeal by the Bureau of Insurance, and the State Corporation Commission will issue a binding order carrying out the recommendation of the impartial health entity. These appeals provisions become effective either (i) 90 days following the promulgation of regulations by the State Corporation Commission or (ii) July 1, 2000.

The bill also establishes an Office of Managed Care Ombudsman within the Bureau of Insurance. The Managed Care Ombudsman is charged with promoting and protecting the interests of covered persons under managed care health insurance plans in Virginia. The duties of the Managed Care Ombudsman include assisting persons in understanding their rights and processes available to them under their managed care plan, developing information on the types of managed health insurance plans available in Virginia, and monitoring and providing information to the General Assembly on managed care issues.

HB 2613 - Passed House (99-Y 0-N) with amendments; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: Brian J. Moran
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Health care provider panels; continuity of care. Requires health insurance plans and health maintenance organizations to provide 90 days notice to enrollees prior to terminating providers, and to allow enrollees to continue using a terminated provider for 90 days. The bill also allows pregnant women to continue receiving treatment from a terminated provider through delivery, and the terminally ill to continue receiving treatment from such a provider until death.

HB 2614 - Stricken from docket by Corporations, Insurance & Banking (26-Y 0-N)
Patron: Viola D. Baskerville
Alzheimer's Association position: SUPPORT
Summary:
Prescription drug formularies. Requires any prescription drug formulary applied by any (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis; (ii) corporation providing individual or group accident and sickness subscription contracts; and (iii) health maintenance organization providing a health care plan for health care services to be developed only after consultation and approval by a pharmacy and therapeutics committee made up of a majority of members who are licensed physicians. The bill also requires each insurer, corporation, or health maintenance organization to establish an expeditious process or procedure that allows covered individuals to obtain appropriate nonformulary drugs without prior approval.

HB 2619 - Incorporated in other legislation (HB2578-Baskerville)
Patron: S. Chris Jones
Alzheimer's Association position:
Summary:
Prescription drug formularies. Requires any prescription drug formulary applied by any (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis; (ii) corporation providing individual or group accident and sickness subscription contracts; and (iii) health maintenance organization providing a health care plan for health care services to be developed only after consultation and approval by a pharmacy and therapeutics committee made up of a majority of members who are licensed physicians. The bill also requires each insurer, corporation, or health maintenance organization to establish an expeditious process or procedure that allows covered individuals to obtain appropriate nonformulary drugs without prior approval. The covered individual would be responsible for the payment of any costs of the nonformulary prescription drug which exceeds the cost the insurer, corporation, or health maintenance organization would pay for the prescription drug on the formulary which is intended to address the medical condition of the enrollee for which the nonformulary drug is prescribed.

HB 2620 - Stricken from docket by Health, Welfare and Institutions (22-Y 0-N)
Patron: S. Chris Jones
Alzheimer's Association position:
Summary:
Patient health records. Clarifies that permitted disclosures of patient records include disclosures by providers made pursuant to mandatory reporting requirements. Providers may also disclose records (i) to third-party payors and their agents whenever the patient or a person acting on a patient's behalf has so requested for payment under a contract or insurance policy, (ii) pursuant to a medical temporary detention order, (iii) to both custodial and noncustodial parents of a minor as permitted by law, and (iv) by exchange when a person committed to jail is transferred to another facility. The bill also permits providers to charge a reasonable fee for requests for copies of medical records. There are technical amendments.

HB 2645 - Passed House (100-Y 0-N) with Committee Substitute and Floor Amendment; Referred to Senate Committee on Commerce and Labor; Left in Commerce and Labor; Incorporated in other legislation (HB871-Griffith)
Patron: Dwight Clinton Jones
Alzheimer's Association position: SUPPORT
Summary as Passed House:
Accident and sickness insurance; access to specialists; standing referrals. Requires each (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription contracts, and (iii) health maintenance organization providing a health care plan for health care services to provide access to specialists for those individuals with ongoing special conditions. Each insurer, corporation or health maintenance organization is required to develop procedures whereby a covered individual with an ongoing special condition may receive a standing referral to a specialist. Insurers, corporations, and health maintenance organizations may require a specialist to provide written notification to the individual's primary care physician, including a description of the services rendered.

HB 2690 - Reported from Corporations, Insurance & Banking with substitute (24-Y 1-N); Referred to Committee on Appropriations; Failed to report (defeated) in Appropriations (14-Y 15-N)
Patron: Johnny S. Joannou
Alzheimer's Association position: SUPPORT
Summary:
Health insurance; assignment of benefits. Prohibits health care coverage plan providers from refusing to accept assignments of benefits executed by covered individuals in favor of health care providers and hospitals. The bill is applicable to (i) insurers issuing individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, (ii) corporations providing individual or group accident and sickness subscription contracts, (iii) health maintenance organizations providing health care plans for health care services, and (iv) dental services plan offering or administering prepaid dental services. An "assignment of benefits" is the transfer of health care coverage reimbursement benefits or other rights under an insurance policy, subscription contract or health care plan by an insured, subscriber or plan enrollee to a health care provider or hospital.

HB 2707 - Failed to report (defeated) in Corporations, Insurance & Banking with substitute (12-Y 13-N)
Patron: Kathy J. Byron
Alzheimer's Association position:
Summary:
Special Advisory Commission on Managed Care Health Insurance Plans; Office of Managed Care Ombudsman. Establishes the Special Advisory Commission on Managed Care Health Insurance Plans, comprised of 14 members and two ex officio members. The Special Advisory Commission is charged with (i) developing and maintaining, with the Bureau of Insurance, a system and program of data collection to assess the impact, including costs to employers and insurers, impact of treatment, cost savings in the health care system, number of providers and other data on managed care health insurance plans as may be appropriate, and (ii) advising and assisting the Bureau of Insurance and the Department of Health on matters relating to managed care health insurance plan benefits and provider regulations. The bill also creates, within the office of the Attorney General's Division of Consumer Counsel, an Office of Managed Care Ombudsman. The ombudsman will promote and protect the interests of covered persons under managed care health insurance plans in the Commonwealth, and coordinate with the Special Advisory Commission on Managed Care Health Insurance Plans in studies relating to the enforcement and improvement of managed care health insurance plans and provider regulations.

HB 2732 - Engrossment refused by House (48-Y 51-N 1-A)
Patron: John H. Tate, Jr.
Alzheimer's Association position: SUPPORT
Summary:
Accident and sickness insurance; access to specialists. Requires each (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription contracts, and (iii) health maintenance organization providing a health care plan for health care services to allow covered individuals to designate a specialist as their primary care doctor.

HB 2742 - Incorporated in other legislation (HB2193-Tate)
Patron: Franklin P. Hall
Alzheimer's Association position: SUPPORT
Summary:
Income tax; tax credit for caregivers. Provides a $500 tax credit to taxpayers with Virginia adjusted gross incomes between $5,000 and $50,000 who provide unreimbursed care to a physically or mentally impaired relative who required assistance with two or more activities of daily living during more than half the year. The credit will be available for taxable years beginning on and after January 1, 2000, and only one credit shall be allowed annually for each impaired individual receiving care.

HJ 547 - Passed by in Rules (15-Y 0-N); Letter to Joint Commission on Health Care
Patron: Lionell Spruill, Sr.
Alzheimer's Association position: SUPPORT
Summary:
Nursing home and adult care residence staffing guidelines. Directs the Joint Commission on Health Care to review staffing guidelines for nursing homes and facilities and adult care residences to determine whether staffing requirements currently in effect in the Commonwealth adequately protect the health, safety and welfare of nursing home and facility and adult care residence residents. Such review shall also include the adequacy of the enforcement of such staffing guidelines, and a recommendation for enhanced staffing guidelines based on objective data resulting from the study.

HJ 677 - No action taken by Rules
Patron: Gladys B. Keating
Alzheimer's Association position: SUPPORT
Summary:
Resolution; physician-assisted living. Expresses the sense of the General Assembly that physicians and other health care professionals should be taught to implement and should adopt the philosophy of physician-assisted living for terminally ill patients. The General Assembly also expresses its belief that protocols for physician-assisted living require that terminally ill patients be provided access to effective palliative care and sensitive concern for their emotional and spiritual needs. Physician-assisted living is a system of care involving a multidisciplinary team of professionals to provide physical and mental care, including pain medication and complementary care (massage, whirlpools, heat, acupuncture, biofeedback, etc.) as well as psychological and spiritual assistance.

HJ 681 - Incorporated in other legislation (HJ552-Hamilton)
Patron: Robert H. Brink
Alzheimer's Association position: SUPPORT
Summary:
Memorializing Congress; ERISA regulation of employer-based health plans. Memorializes Congress to consider amending ERISA to grant authority to all individual states to monitor and regulate self-funded employer-based health plans in order to provide greater consumer protection and effect health care reforms.

HJ 696 - No action taken by Finance
Patron: Harvey B. Morgan
Alzheimer's Association position: SUPPORT
Summary:
Study resolution; long term care insurance tax credit. Requests the Department of Taxation to study the possibility of the Commonwealth providing an income tax credit to individuals who purchase long term care health insurance. The Department will report its findings to the 2000 General Assembly.