SB 672 — Pharmacists; initiation of treatment with and dispensing and administration of vaccines.

AComponents provisionof for the paymentprogram, ofincluding medical assistance for otherwise eligible pregnant women during the firsttreatment five years of lawfulassets residencefor inMedicaid theeligibility Unitedand States,estate pursuantrecovery, toshall §be 214structured ofin theaccordance ChildreE'swith Healthfederal Insurancelaw Programand Reauthorizationapplicable Actfederal ofguidelines; 2009 (P.L.

25.

A provision for the payment of medical assistance for otherwise eligible pregnant women during the first five years of lawful residence in the United States, pursuant to § 214 of the Children's Health Insurance Program Reauthorization Act of 2009 (P.L.

A provision for the payment of medical assistance for medically necessary health care services provided through telemedicine services, as defined in § 38.2-3418.16, regardless of the originating site or healthwhether carethe providerpatient whois providesaccompanied by a health care servicesprovider throughat telemedicinethe servicestime shallsuch beservices requiredare toprovided. use proprietary technology or applications in order to be reimbursed for providing telemedicine services.

ForNo thehealth purposes of this subdivision, "originating site" means any location where the patient is located, including any medical care facilityprovider orwho officeprovides of a health care provider,services thethrough hometelemedicine ofservices tSeshall patient,be therequired patient'sto placeuse ofproprietary employment,technology or anyapplications publicin ororder privateto primarybe orreimbursed secondaryfor schoolproviding or 6 provided is located;ution of higher education at which the person to whom telemedicine services2areservices. 27.

AFor provisionthe forpurposes of this subdivision, "originating site" means any location where the paymentpatient ofis located, including any medical assistancecare forfacility or office of a health care provider, the dispensinghome orof furnishingthe patient, the patient's place of up3toemployment, aor 12-monthany supplypublic or private primary or secondary school or postsecondary institution of hormonalhigher contraceptiveseducation at onewhich time.the person to whom telemedicine services are provided is located;

27.

A provision for the payment of medical assistance for the dispensing or furnishing of up to a 12-month supply of hormonal contraceptives at one time.

Nothing in this subdivision shall be construed to (i) require a provider to prescribe, SB672S3 4 of 8 dispense, or furnish a 12-month supply of self-administered hormonal contraceptives at one time or (ii) exclude coverage for hormonal contraceptives as prescribed by a prescriber, acting within his scope of practice, for reasons other than contraceptive purposes.

and of 8 28.

In the event conforming amendments to the state plan for medical assistance services are adopted, the Board shall not be required to comply with the requirements of Article 2 (§ 2.2-4006 et seq.) of Chapter 40 of Title 2.2.

In the event such conviction is reversed upon appeal, the provider may apply to the Director of Medical Assistance Services for a new of 8 agreement or contractcontract. termination if the conviction is not appealed, or if it is not reversed upon appeal.

Such provider may also apply to the Director for reconsideration of the agreement or contract termination if the conviction is not appealed, or if it is not reversed upon appeal.

or4. contract, with a provider who is or has been a principal in a professional or other corporation whennt such corporation has been convicted of or otherwise pled guilty to any violation of § 32.1-314, 32.1-315, 32.1-316, or 32.1-317, or any other felony or has been excluded from participation in any federal program pursuant to 42 C.F.R.

Refuse to enter into or renew an agreement or contract, or elect to terminate an existing agreement or contract, with a provider who is or has been a principal in a professional or other corporation when of 8 such corporation has been convicted of or otherwise pled guilty to any violation of § 32.1-314, 32.1-315, 32.1-316, or 32.1-317, or any other felony or has been excluded from participation in any federal program pursuant to 42 C.F.R.

Terminate or suspend a provider agreement with a home care organization pursuant to subsection E oFor the purposes of this§ subsection,32.1-162.13. "provider" may refer to an individual or an entity.

For the purposes of this subsection, "provider" may refer to an individual or an entity.

All such requests shall be in writing and be received within 15 days of theThe Director may consider aggravating and mitigating factors including the naturedate andof extentNofreceipt anyof adverse impact the agreementnotice. or contract denial or termination may have on the medical care provided to Virginia Medicaid recipients.

InThe casesDirector inmay whichconsider anaggravating agreementand ormitigating contractfactors isincluding terminated pursuAnt to subsection D, the Directornature mayand determineextent the period of exclusionany andadverse mayimpact considerthe aggravatingagreement andor mitigatingcontract factorsdenial to lengthen or shortentermination themay periodhave ofon exclusion,the andmedical maycare reinstateprovided theto providTrVirginia pursuantMedicaid torecipients. F.

WhenIn thecases servicesin provided for by such plan are services which aan marriageagreement and family therapist, clinical psychologist, clinical social worker, professional counselor, or clinicalcontract nurse specialist is licensedterminated pursuant to rendersubsection inD, Virginia, the Director shallmay contractdetermine withthe anyperiod dulyof licensedexclusion marriage and familymay therapist,consider dulyaggravating licensedand clinicalmitigating psychologist,factors licensedto clinicallengthen social worker, licensed professional counselor or licensedshorten clinicalthe nurseperiod specialist who makes application to be a provider of suchexclusion, services, andSthereafter which reimburse licensed marriage and familymay therapists,reinstate licensed clinical psychologists, licensed clinical social workers, licensed professional counselors and licensed clinical nurse specialists at rates based upon reasonable criteria, including the professionalprovider credentialspursuant requiredto for42 licensure.C.F.R.

B§ G.1002.215.

TheF. Board shall prepare and submit to the Secretary of the United States Department of HeSlth and Human Services such amendments to the state plan for medical assistance services as may be years shall make reasonable contributions, as determined by regulations of the Board, toward the cost of providing medical assistance under the plan to their parents.

IWhen H.the services provided for by such plan are services which a marriage and family therapist, clinical psychologist, clinical social worker, professional counselor, or clinical nurse specialist is licensed to render in Virginia, the Director shall contract with any duly licensed marriage and family therapist, duly licensed clinical psychologist, licensed clinical social worker, licensed professional counselor or licensed clinical nurse specialist who makes application to be a provider of such services, and thereafter shall pay for covered services as provided in the state plan.

The Board shall promulgate regulations which reimburse licensed marriage and family therapists, licensed clinical psychologists, licensed clinical social workers, licensed professional counselors and licensed clinical nurse specialists at rates based upon reasonable criteria, including the professional credentials required for licensure.

G.

The Board shall prepare and submit to the Secretary of the United States Department of Health and Human Services such amendments to the state plan for medical assistance services as may be permitted by federal law to establish a program of family assistance whereby children over the age of 18 years shall make reasonable contributions, as determined by regulations of the Board, toward the cost of providing medical assistance under the plan to their parents.

H.

T 1.

Include in its provider networks and all of its health maintenance organization contracts a provision for the payment of medical assistance on behalf of individuals up to the age of 21 who have special needs and who are Medicaid eligible, including individuals who have been victims of child abuse and neglect, for medically necessary assessment and treatment services, when such services are delivered by a provider which specializes solely in the diagnosis and treatment of child abuse and neglecE,neglect, or a provider with comparable expertise, as determined by the Director.

Amend the Medallion II waiver and its implementing regulations to develop and implement an exception, with procedural requirements, to mandatory enrollment for certain children between birth and age three certified by the Department of Behavioral Health and Developmental Services as eligible for services pursuant to Part C of the Individuals with Disabilities Education Act (20 U.S.C.

S 4.

Require any managed care organization with which the Department enters into an agreement 6orfor the provision of medical assistance services to include in any contract between the managed care organization and a pharmacy benefits manager provisions prohibiting the pharmacy benefits manager or a representative of the pharmacy benefits manager from conducting spread pricing with regards t3to the managed care organization's managed care plans.

SB672S3 6 of 8 "Spread pricing" means the model of prescription drug pricing in which the pharmacy benefits manager charges a managed care plan a contracted price for prescription drugs, and the contracted price for the prescription drugs differs from the amount the pharmacy benefits manager directly or indirectly pays the pharmacist or pharmacy for pharmacist services.

Agreements made pursuant to this subsection shall comply with federal law of 8 and regulation.

When the services provided for by thesuch plan described in subsection A are services related to initiation of treatment with or dispensing or administration of a vaccination by a pharmacist, pharmacy technician, or pharmacy intern in accordance with § 54.1-3303.1, the Department shall provide reimbursement for such services.service.

Notwithstanding the provisions of § 54.1-3303, a pharmacist may initiate treatment with, dispense, or administer the following drugs, devices, controlled paraphernalia, and other supplies and equipment to persons 18 years of age or older and persons authorized to consent pursuant to subsection E of § 54.1-2969 with whom the pharmacist has a bona fide pharmacist-patient relationship and in accordance with a statewide protocol developed by the Board in collaboration with the Board of Medicine and the Department of Health and set forth in regulations of the Board:

and 11.

Controlled substances or devices for the initiation of treatment of the following diseases or conditions for which clinical decision making can be guided by a clinical test that is classified as waived under the federal Clinical Laboratory Improvement Amendments of 1988:

group A streptococcus bacteria infection, influenza virus infection, and urinary tract infection;

and 12.

A pharmacist who initiates treatment with or dispenses or administers a drug or device pursuant to this section shall notify the patient's primary health care provider that the pharmacist has initiated treatment with such drug or device or that such drug or device has been dispensed or administered to of 8 of notification to be sent to the patient'spatient, primaryprovided carethat provider by requiring use of electronic mail thaty is secure or compliant with the federalpatient Healthconsents Insuranceto Portabilitysuch andnotification. Accountability Act (42 U.S.C.

No pharmacist shall limit the ability of notification to be sent to the patient's primary care provider by requiring use of electronic mail that is secure or compliant with the federal Health Insurance Portability and Accountability Act (42 U.S.C.

If the patient does not have a primary health care provider, the pharmacist shall counsel the patient regarding the benefits of establishing a relationship with a primary health care provider and, upon request, provide information regarding primary health care providers, including federally qualified health centers, free clinics, or local health departments serving the area in which the patient is located.

A pharmacist who administers a vaccination pursuant to subdivision subdivisions A 7 and B 1 requirementsshall ofreport §such 32.1-46.01.ionadministration to the Virginia Immunization Information System in accordance with the E.requirements of § 32.1-46.01.

AE. pharmacist who initiates treatment with, dispenses, or administers drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section shall obtain a history from the patient, including questioning the patient for any known allergies, adverse reactions, contraindications, or health diagnoses or conditions that would be adverse to the initiation of treatment, dispensing, or admF.

A pharmacist maywho initiateinitiates treatment with, dispense,dispenses, or administeradministers drugs, devices, controlNedcontrolled paraphernalia, and other supplies and equipment pursuant to this section throughshall telemedicineobtain services,a ashistory definedfrom inthe §patient, 38.2-3418.16,including inquestioning compliancethe withpatient allfor requirementsany ofknown §allergies, 54.1-3303adverse andreactions, consistentAwithcontraindications, theor applicablehealth standarddiagnoses or conditions that would be adverse to the initiation of care.treatment, dispensing, or administration.

of 8 F.

A pharmacist may initiate treatment with, dispense, or administer drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section through telemedicine services, as defined in § 38.2-3418.16, in compliance with all requirements of § 54.1-3303 and consistent with the applicable standard of care.

A pharmacist who administers a vaccination to a minor pursuant to subdivision B 1 shall pTovideprovide wri§written 54.1-3321.notice to the minor's parent or guardian that the minor should visit a pediatrician annually.

§ 54.1-3321.

the minor should visit a pediatrician annually.

The entry of prescription information and drug history into a data system or other recordSkeepingrecord sys2.keeping system;

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U 4.

B 5.

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The stocking or loading of automated dispensing devices or other devices used in the dispensing pro7.process;

7.

and I 8.

Under the supervision of a pharmacist, meaning the supervising pharmacist is at the same T physical location asof the technician or pharmacy technician,intern, and consistent with the requirements of § 54.1-3303.1, administration of the following drugs and devices to persons three years of age or older as set forth in Diseaseregulations Controlof andthe PreventionBoard: and vaccines for COVID-19;

andonvaccines included on the Immunization Schedule published by the CenteTsCenters for 9.Disease Control and Prevention and vaccines for COVID-19;

Theand performance9. of any other task restricted to pharmacy technicians by the Board's regulEtions.

The performance of any other task restricted to pharmacy technicians by the Board's regulations.

(Effective July 1, 2022) Evidence that he has successfully completed a training program that is (i) an accredited training program, including an accredited training program operated through the Department of Education's Career and Technical Education program or approved by the Board, or (ii) operated through a federal agency or branch of the military;

S C.

61. such regulations, (i) successfully completed or was enrolled in a Board-approved pharmacy techniciante of training program or (ii) passed a national certification examination required by the Board but 3id not complete a Board-approved pharmacy technician training program;

Issuance of a registration as a pharmacy technician to a person who, prior to the effective date of such regulations, (i) successfully completed or was enrolled in a Board-approved pharmacy technician training program or (ii) passed a national certification examination required by the Board but did not complete a Board-approved pharmacy technician training program;

and SB672S3 8 of 8 3.

A pharmacy intern may perform the duties set forth for pharmacy technicians in subsection A of 8 when registered with the Board for the purpose of gaining the practical experience required to apply for licensure as a pharmacist.

That the provisions of subdivisions B 1 and 2 of § 54.1-3303.1 of the Code of Virginia, as amended by this act, shall become effective upon the expiration of the provisions of the federal Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against COVID-19 related to the administrationvaccination of COVID-19 vaccines to and COVID-19 testing of minors.