On Apr. 8, 2022, VA LEG Governor approved bill HB 360 which was enacted into law.
Bill, Act chaptered as Chapter 284 effective if reenacted in 2023 session.
Document dated Apr. 8, 2022, was received on Aug. 22, 2022 due to a new feed.
In Feb. 2023, VA LEG bill would require online electronic authorization, see #164501.
On Feb. 24, VA LEG reported bill on prescription drug information.
VA LEG passed HB 360, which requires carrier or its pharmacy benefits manager to furnish information to health care provider or authorized third party upon request.
Prescription Drug Information
House Bill 360 required health insurance carriers to establish, maintain an online process that links directly to e-prescribing systems, electronic health record systems.
Systems that utilize national council for prescription drug programs SCRIPT standard.
Process needs to accept electronic prior authorization requests from provider.
Can approve electronic prior authorization requests for which no additional information is needed by carrier to process prior authorization request; no clinical review required.
Prohibited carrier from imposing charge/fee on participating health care provider for accessing online process/provider data via online process other than for enrollee.
Required participating health care providers to ensure that system has ability to access electronic prior authorization process established by carrier and real time cost information data for a covered prescription drug made available by a carrier.
Provider may request waiver of compliance for undue hardship for 12 month period.
Carrier or its pharmacy benefits manager must provide real-time cost information data to enrollees, contracted providers for covered prescription drug, including any cost-sharing requirement or prior authorization requirements; ensure data is accurate.
Cost information data must be available to provider in format that provider can access.
Work Group
Bill also required state corporation commission's bureau of insurance to establish a work group in coordination with secretary of health and human resources.
Work group will assess current status of electronic prior authorization, make recommendations regarding the implementation of electronic prior authorization.
Including single standardized process, suggestion for statutory/regulatory change.
Work group required to include relevant stakeholders, including representatives from parties with interest in underlying technology; including VA association of health plans.
Medical society of VA, nat. council for Rx drug programs, VA hospital, healthcare assn.
Work group must report findings, recommendations to chairmen of Senate committee on commerce, labor; House committee on commerce, energy by Nov. 1, 2022.
Legislative History
On Jan. 11, 2022, bill introduced in House; on Feb. 15, 2022 bill passed House.
On Feb. 16, 2022, bill introduced in Senate; on Feb. 24, 2022 bill passed Senate
Effectiveness
Workgroup findings are required to be reported to committees by Nov. 1, 2022.
Each health insurance carrier must establish online process beginning Jul. 1, 2025.
Apr. 2022 VA LEG Governor Signed Bill
On Apr. 8, 2022, VA LEG Governor approved bill HB 360 which was enacted into law.
Bill, Act chaptered as Chapter 284 effective if reenacted in 2023 session.
Document dated Apr. 8, 2022, was received on Aug. 22, 2022 due to a new feed.
In Feb. 2023, VA LEG bill would require online electronic authorization, see #164501.
