2018 Legislative Update for Healthcare Practitioners

by Nora T. Ciancio

Now that the 2018 Virginia General Assembly has concluded, we can report on the status of the following bills, which we placed on a “watch list” earlier this year.

Prescribing

HB 333
Purpose: Practitioners would be able to prescribe opioids for the purpose of managing pain associated with cancer for more than 7-days without requesting information from the PMP.
Status: This bill was left in the Committee on Health, Welfare, and Institutions

HB 974
Purpose: The passage of HB 974 would allow individuals in the Commonwealth to possess marijuana or THC for any terminal or debilitating medical conditions pursuant to a valid written certificate issued by a licensed health care professional. Physicians and pharmacists would be allowed to distribute these cannabis products without being subject to prosecution.
Status: This bill was left in the Committee for Courts and Justice.

HB 1064
Purpose: HB 1064 would grant an allowance to individuals to possess marijuana or THC for any medical condition pursuant to an appropriate certificate.
Status: This bill was also left in the Committee for Courts and Justice.

HB 1173
Purpose: This bill proposed to eliminate the opioid prescribing exception that currently dictates that practitioners do not have to query the Prescription Monitoring Program (PMP) for opioid prescriptions issued for up to 14 days for treatment for surgical or invasive procedures.
Status: HB 1173 has passed the House with a vote of 99-Yes, 0-No and passed the Senate with a vote of 40-Yes, 0-No. The Governor approved it on March 2nd, 2018.
Impact: Beginning July 1, 2018, practitioners will need to check patients’ PMPs more frequently when treating for surgical or invasive procedures.

SB 464
Purpose: This bill increased the requirements for practitioners treating patients with opioid addictions. Under this bill, such practitioners utilizing methadone or other opioid replacements would need to comply with PMP reporting requirements.
Status: The bill was passed by indefinitely in the Senate Committee on Education and Health.

Changes to Prior Authorization

SB 581
Purpose: SB 851 mandated that a specific provision must be included in contracts between an insurance carrier and participating health care provider that requires prior authorization for drug benefits. The proposed provision would grant practitioners the right to a peer-to-peer review when a prior authorization request is denied under the contract.
Status: This bill was passed by indefinitely in Commerce and Labor.

SB 731
Purpose: Another bill involving prior authorization policy, SB 731 aims to increase protection for participating providers in contracts with insurance carriers that require prior authorization for surgical procedures and drug benefits by specifying provisions that must be included in the contracts. The provisions will prohibit carriers from retracting approval or from refusing to pay claims submitted once approval has already been granted. Additionally, the bill exempts prior authorization for drug benefits in instances where 90% or more of the prior authorization requests from the provider have been approved within the last 12 months. Generic drugs will also be exempt from prior authorization.
Status: This bill was continued to the 2019 Session, so it may be one to watch next year.

Scope of Practice

HB 793
Purpose: The proposed language of HB 793 eliminated the requirement for Nurse Practitioners who have completed 1,040 hours of clinical experience to enter into practice agreements. NPs would also be able to serve as the “collaborating provider” for less experienced NPs who have not yet met the clinical hour requirement.
Status:  A substitute for this bill was proposed and subsequently passed both the House and Senate. The substitution eliminates the requirement for 1040 hours of clinical experience, instead now requiring the equivalent of at least five years of full-time clinical experience.  The Governor‘s deadline to sign this bill into law is midnight on April 9, 2018.

SB 511
Purpose: SB 511 broadened the scope of practice for optometrists to include the evaluation, examination, diagnosis, and treatment of abnormal conditions of the human eye and its adnexa through the use of medically recognized and appropriate devices, procedures, or technologies. The bill, however, specified that the scope of practice still cannot include any treatment by laser surgery , most treatment by surgery, or the use of injections (except for certain injections by TPA-certified optometrists and for intramuscular epinephrine injections for the treatment of anaphylactic shock).
Status: This bill passed the Senate and the House and was approved by the Governor on March 9, 2018.
Impact: As of July 1, 2018, Optometrists will have broader authority to evaluate, diagnose and treat abnormal conditions.

Authority of DHP

HB 1114
Purpose: This bill granted authority to the Department of Health Professions to suspend or revoke the certificates, registration or licenses of any health professionals who is in default or delinquent in the payment of state or federal educational loans. The bill passed in the House on February 5th.
Status: The Governor approved this bill on March 5, 2018.
Impact: This new law may lead to increased actions by the DHP against practitioners.

HB 1071
Purpose: HB 1071 granted authority to the Board of Medicine, the Board of Nursing, and the Board of Funeral Directors and Embalmers to send notices for license renewals electronically.
Status: This bill passed without opposition in both the House and Senate. It was approved by the Governor on March 2, 2018.
Impact: Practitioners should watch their emails for important correspondence!

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