Legislative Update for Virginia Hemophilia Foundation
Friday March 7, 2025

Bill	Patron	Title	Synopsis	Status
HB 1700	Nadarius E. Clark	School Boards; Bleeding Control Programs, Bleeding Control Kits.	School boards; bleeding control programs; bleeding control kits; immunity from civil liability. Requires each school board to develop and implement a bleeding control program in each public elementary and secondary school in the local school division whereby the school board, among other things, requires bleeding control kits with certain enumerated contents such as bandages and tourniquets to be placed in each public elementary and secondary school building in easily accessible locations and certain school board employees to obtain appropriate training in the use of the kit. The bill also provides that any such employee who uses such a kit to control bleeding shall not be liable for any civil damages for ordinary negligence in acts or omissions resulting from such use.	H Senate substitute agreed to by House (77-Y 19-N) (2/20)
HB 1724	Ellen H. Campbell; Kannan Srinivasan; Nadarius E. Clark; Karrie K. Delaney	Prescription Drug Affordability Board; Established, Drug Cost Affordability Review, Report.	Prescription Drug Affordability Board established; drug cost affordability review. Establishes the Prescription Drug Affordability Board for the purpose of protecting the citizens of the Commonwealth and other stakeholders within the health care system from the high costs of prescription drug products. The bill requires the Board to meet in open session at least four times annually, with certain exceptions and requirements enumerated in the bill. Members of the Board are required to disclose any conflicts of interest, as described in the bill. The bill also creates a stakeholder council for the purpose of assisting the Board in making decisions related to drug cost affordability. The bill tasks the Board with identifying prescription, generic, and other drugs, as defined in the bill, that are offered for sale in the Commonwealth and, at the Board's discretion, conducting an affordability review of any prescription drug product. The bill lists factors for the Board to consider that indicate an affordability challenge for the health care system in the Commonwealth or high out-of-pocket costs for patients. The bill also provides that any person aggrieved by a decision of the Board may request an appeal of the Board's decision and that the Attorney General has authority to enforce the provisions of the bill. The bill provides that the Board shall establish no more than 12 upper payment limit amounts annually between January 1, 2026, and January 1, 2029. The bill requires the Board to annually report its findings and recommendations to the General Assembly, beginning on December 31, 2026. Provisions of the bill apply to state-sponsored and state-regulated health plans and health programs and obligate such policies to limit drug payment amounts and reimbursements to an upper payment limit amount set by the Board, if applicable, following an affordability review. The bill specifies that Medicare Part D plans are not bound by such decisions of the Board. The bill also requires the nonprofit organization contracted by the Department of Health to provide prescription drug price transparency to provide the Board access to certain data reported by manufacturers. The bill has a delayed effective date of January 1, 2026.	H Fiscal Impact Statement from Department of Planning and Budget (HB1724) (2/19)
HB 2107	H. Otto Wachsmann, Jr.	Health Insurance; Pharmacies, Freedom Of Choice, Delivery Of Prescription Drugs, Penalties.	Health insurance; pharmacies; freedom of choice; delivery of prescription drugs; penalties. Prohibits an insurer, health maintenance organization, corporation providing preferred provider subscription contracts, or pharmacy benefits manager from imposing upon any person receiving pharmaceutical benefits any policy or practice requiring or incentivizing certain provisions relating to the delivery of prescription drugs. A violation of the bill's provisions constitutes an unfair trade practice under existing law and is subject to injunctive, penalty, and enforcement provisions in existing law.	H Left in Labor and Commerce (2/5)
HB 2258	Karrie K. Delaney	Bureau Of Insurance Of Scc; Step Therapy Protocols For Health Benefit Plans, Report.	Bureau of Insurance; step therapy protocols; study; report. Directs the Bureau of Insurance of the State Corporation Commission to study step therapy protocols for health benefit plans developed by insurance companies pursuant to existing law by conducting a data call of health carriers. The bill directs the Bureau to submit a summary and report of its findings and recommendations to the Governor and General Assembly by November 1, 2026.	S Passed Senate (40-Y 0-N) (2/19)
HB 2375	Mark D. Sickles	Prescription Drug Price Transparency; Pharmacy Services Administrative Organizations.	Prescription drug price transparency; pharmacy services administrative organizations. Requires pharmacy services administrative organizations to submit information on reimbursement rates and fees to the nonprofit data services organization that contracts with the Department of Health to provide prescription drug price transparency information. Under the bill, a pharmacy services administrative organization that solely generates revenue from charging flat service fees to pharmacies and does not charge pharmacies for services based on prescription drug prices or volume is exempt from submitting such information.	S Passed Senate (40-Y 0-N) (2/18)
HB 2380	M. Keith Hodges	Hhr, Secretary Of; Pharmacy Benefits Manager & Third-party Administrator Oversight Work Group.	Secretary of Health and Human Resources; Pharmacy Benefits Manager and Third-Party Administrator Oversight Work Group; report. Directs the Secretary of Health and Human Resources, in consultation with the Attorney General, to convene the Pharmacy Benefits Manager and Third-Party Administrator Oversight Work Group to examine the impact of Rutledge v. Pharmaceutical Care Management Association, 141 S. Ct. 474 (2020), and to formulate legislative recommendations for reducing prescription drug costs, minimizing health care expenses, reducing bureaucratic impediments to affordable health care, enhancing transparency, and improving overall health outcomes for residents of the Commonwealth. The bill requires the Work Group to submit a report of its findings and recommendations to the General Assembly by November 1, 2026.	H Tabled in Rules (14-Y 0-N) (1/29)
HB 2392	Mark D. Sickles	Health Insurance; Pharmacy Benefits Managers, Definition Of "covered Entity."	Health insurance; pharmacy benefits managers; definition of covered entity. Removes hospitals, as defined in existing law, from the exemption to the definition of covered entity for the purposes of existing law relating to pharmacy benefits managers. This bill is identical to SB 1311.	G Governor's Action Deadline 11:59 p.m., March 24, 2025 (3/3)
HB 2394	Mark D. Sickles	Medicaid; Long-term Services And Supports, Presumptive Eligibility, Sunset.	Department of Medical Assistance Services; Medicaid; long-term services and supports; presumptive eligibility; sunset. Directs the Department of Medical Assistance Services to provide presumptive eligibility for Medicaid, including long-term services and supports where appropriate, to individuals who meet certain criteria. The provision of presumptive eligibility is conditional on the Department obtaining all necessary approvals and federal financial participation. The bill will sunset on January 1, 2026 if such approval and federal financial participation is not obtained.	H Left in Appropriations (2/4)
HB 2610	H. Otto Wachsmann, Jr.; Joshua G. Cole; Kannan Srinivasan; Terry G. Kilgore; Katrina Callsen	State Pharmacy Benefits Manager; Dmas To Select & Contract With A Third-party Administrator To Serve	Department of Medical Assistance Services; state pharmacy benefits manager; independent evaluation. Requires the Department of Medical Assistance Services by July 1, 2026, to select and contract with a third-party administrator to serve as the state pharmacy benefits manager to administer all pharmacy benefits for Medicaid recipients, including recipients enrolled in a managed care organization. The bill enumerates requirements for the Department's contract with the state pharmacy benefits manager. In addition, the bill directs the Department to engage an independent consultant to evaluate the implementation of a contract with a third-party pharmacy benefits manager pursuant to the bill. This bill incorporates HB 2209 and is identical to SB 875.	C Amended by conference committee (2/22)
SB 1078	Mark J. Peake	Health Insurance; Cost-sharing, Pharmacy Benefits Managers, Compensation And Duties, Civil Penalty.	Health insurance; cost-sharing; pharmacy benefits managers; compensation and duties: civil penalty. Amends provisions related to rebates provided by carriers and health benefit plans to health plan enrollees by defining 'defined cost-sharing,' 'pharmacy benefits management services,' and 'price protection rebates.' The bill requires that an enrollee's defined cost-sharing for each prescription drug be calculated at the point of sale based on a price that is reduced by an amount equal to at least 80 percent of all rebates received or expected to be received in connection with the dispensing or administration of the prescription drug. The bill prohibits a pharmacy benefits manager from deriving income from pharmacy benefits management services provided to a carrier or health benefit plan except for income derived from a pharmacy benefits management fee. The bill requires the amount of any pharmacy benefits management fees to be set forth in the agreement between the pharmacy benefits manager and the carrier or health benefit plan and that such fee not be based on the acquisition cost or any other price metric of a drug; the amount of savings, rebates, or other fees charged, realized, or collected by or generated based on the activity of the pharmacy benefits manager; or the amount of premiums, deductibles, or other cost-sharing or fees charged, realized, or collected by the pharmacy benefits manager from enrollees or other persons on behalf of an enrollee. The bill requires a pharmacy benefits manager to annually certify to the State Corporation Commission that it has met certain requirements. The Commission is directed to impose a civil penalty not to exceed $1,000 per claim for a violation of these provisions. The bill establishes a pharmacy benefits manager duty, which includes the duties of care, good faith, and fair dealing, owed to any enrollee, provider, or health benefit plan that receives pharmacy benefits management services from the pharmacy benefits manager or that furnishes, covers, receives, or is administered a unit of a prescription drug for which the pharmacy benefits manager has provided pharmacy benefits management services. The bill requires the Commission to define by regulation the scope of such duty and provides for a private cause of action for any person aggrieved by the breach of such duty.	S Failed to report (defeated) in Commerce and Labor (5-Y 10-N) (1/20)