HB 680 — Medical assistance services; state plan, case management service, individuals w/severe brain injury.

11.

A provision for payment of medical assistance for annual pap smears;

12.

A provision for payment of medical assistance services for prostheses following the medically necessary complete or partial removal of a breast for any medical reason;

13.

A provision for payment of medical assistance which provides for payment for 48 hours of inpatient treatment for a patient following a radical or modified radical mastectomy and 24 hours of inpatient care following a total mastectomy or a partial mastectomy with lymph node dissection for treatment of disease or trauma of the breast.

Nothing in this subdivision shall be construed as requiring the provision of inpatient coverage where the attending physician in consultation with the patient determines that a shorter period of hospital stay is appropriate;

14.

A requirement that certificates of medical necessity for durable medical equipment and any supporting verifiable documentation shall be signed, dated, and returned by the physician, physician assistant, or nurse practitioner and in the durable medical equipment provider's possession within 60 days from the time the ordered durable medical equipment and supplies are first furnished by the durable medical equipment provider;

15.

A provision for payment of medical assistance to (i) persons age 50 and over and (ii) persons age 40 and over who are at high risk for prostate cancer, according to the most recent published guidelines of the American Cancer Society, for one PSA test in a 12-month period and digital rectal examinations, all in accordance with American Cancer Society guidelines.

For the purpose of this subdivision, "PSA testing" means the analysis of a blood sample to determine the level of prostate specific antigen;

16.

A provision for payment of medical assistance for low-dose screening mammograms for determining the presence of occult breast cancer.

Such coverage shall make available one screening mammogram to persons age 35 through 39, one such mammogram biennially to persons age 40 through 49, and one such mammogram annually to persons age 50 and over.

The term "mammogram" means an X-ray examination of the breast using equipment dedicated specifically for mammography, including but not limited to the X-ray tube, filter, compression device, screens, film and cassettes, with an average radiation exposure of less than one rad mid-breast, two views of each breast;

17.

A provision, when in compliance with federal law and regulation and approved by the Centers for Medicare & Medicaid Services (CMS), for payment of medical assistance services delivered to Medicaid-eligible students when such services qualify for reimbursement by the Virginia Medicaid program and may be provided by school divisions, regardless of whether the student receiving care has an individualized education program or whether the health care service is included in a student's individualized education program.

Such services shall include those covered under the state plan for medical assistance services or by the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit as specified in § 1905(r) of the federal Social Security Act, and shall include a provision for payment of medical assistance for health care services provided through telemedicine services, as defined in § 38.2-3418.16.

No health care provider who provides health care services through telemedicine shall be required to use proprietary technology or applications in order to be reimbursed for providing telemedicine services;

18.

A provision for payment of medical assistance services for liver, heart and lung transplantation procedures for individuals over the age of 21 years when (i) there is no effective alternative medical or surgical therapy available with outcomes that are at least comparable;

(ii) the transplant procedure and application of the procedure in treatment of the specific condition have been clearly demonstrated to be medically effective and not experimental or investigational;

(iii) prior authorization by the Department of of 6 Medical Assistance Services has been obtained;

(iv) the patient selection criteria of the specific transplant center where the surgery is proposed to be performed have been used by the transplanI team or program to determine the appropriateness of the patient for the procedure;

(v) current medicNl therapy not in an irreversible terminal state;

and (vii) the transplant is likely to prolong the patient's life and restore a range of physical and social functioning in the activities of daily living;

T 19.

A provision for payment of medical assistance for colorectal cancer screening, specificaRly screening with an annual fecal occult blood test, flexible sigmoidoscopy or colonoscopy, or in appropriate circumstances radiologic imaging, in accordance with the most recently published O recommendations established by the American College of Gastroenterology, in consultation with tDe American Cancer Society, for the ages, family histories, and frequencies referenced in such rec20.

A provision for payment of medical assistance for custom ocular prostheses;

U 21.

A provision for payment for medical assistance for infant hearing screenings and all necessary audiological examinations provided pursuant to § 32.1-64.1 using any technology approved by theE United States Food and Drug Administration, and as recommended by the national Joint Committee on Infant Hearing in its most current position statement addressing early hearing detection and intervention programs.

Such provision shall include payment for medical assistance for follow-up audiological examinations as recommended by a physician, physician assistant, nurse practitioner, or audiologist and per22.

A provision for payment of medical assistance, pursuant to the Breast and Cervical Cancer Prevention and Treatment Act of 2000 (P.L.

106-354), for certain women with breast or cervical cancer when such women (i) have been screened for breast or cervical cancer under the Centers for Disease Control and Prevention (CDC) Breast and Cervical Cancer Early Detection Program established under Title XV of the Public Health Service Act;

(ii) need treatment for breast or cervical cancer, iHcluding treatment for a precancerous condition of the breast or cervix;

(iii) are not otherwise covered6under creditable coverage, as defined in § 2701 (c) of the Public Health Service Act;

(iv) are not ot0erwise (v) have not attained age 65.

This provision shall include an expedited eligibility determination for such women;

23.

A provision for the coordinated administration, including outreach, enrollment, re-enrollment and services delivery, of medical assistance services provided to medically indigent children pursuant to this chapter, which shall be called Family Access to Medical Insurance Security (FAMIS) Plus and the FAMIS Plan program in § 32.1-351.

A single application form shall be used to determine eligibility for both programs;

long-term care partnership program between the Commonwealth of Virginia and private insurancelic-private companies that shall be established through the filing of an amendment to the state plan for medical assistance services by the Department of Medical Assistance Services.

The purpose of the program shall be to reduce Medicaid costs for long-term care by delaying or eliminating dependence on Medicaid for such services through encouraging the purchase of private long-term care insurance policies that have been designated as qualified state long-term care insurance partnerships and may be used as the first source of benefits for the participant's long-term care.

Components of the program, including the federal law and applicable federal guidelines;nd estate recovery, shall be structured in accordance with 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.

111-3);

26.

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 whether the patient is accompanied by a health care provider at the time such services are provided.

No use proprietary technology or applications in order to be reimbursed for providing telemedicine services.

For the purposes of this subdivision, "originating site" means any location where the patient is located, including any medical care facility or office of a health care provider, the home of the patient, the patient's place of employment, or any public or private primary or secondary school or postsecondary institution of higher education at which 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 Department shall not impose any utilization controls or other forms of medical management limiting the HB680 4 of 6 supply of hormonal contraceptives that may be dispensed or furnished to an amount less than a 12-month supply.

Nothing in this subdivision shall be construed to (i) require a provider to prescribe, 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.

As used in this subdivision, "hormonal contraceptive" means a medication taken to prevent pregnancy by means of ingestion of hormones, including medications containing estrogen or progesterone, that is self-administered, requires a prescription, and is approved by the U.S.

Food and Drug Administration for such purpose;

and 28.

A provision for payment of medical assistance for remote patient monitoring services provided via telemedicine, as defined in § 38.2-3418.16, for (i) high-risk pregnant persons;

(ii) medically complex infants and children;

(iii) transplant patients;

(iv) patients who have undergone surgery, for up to three months following the date of such surgery;

and (v) patients with a chronic health condition who have had two or more hospitalizations or emergency department visits related to such chronic health condition in the previous 12 months.

For the purposes of this subdivision, "remote patient monitoring services" means the use of digital technologies to collect medical and other forms of health data from patients in one location and electronically transmit that information securely to health care providers in a different location for analysis, interpretation, and recommendations, and management of the patient.

"Remote patient monitoring services" includes monitoring of clinical patient data such as weight, blood pressure, pulse, pulse oximetry, blood glucose, and other patient physiological data, treatment adherence monitoring, and interactive videoconferencing with or without digital image upload;

and 29.

A provision for the payment of medical assistance for targeted case management services for individuals with severe traumatic brain injury.

B.

In preparing the plan, the Board shall:

1.

Work cooperatively with the State Board of Health to ensure that quality patient care is provided and that the health, safety, security, rights and welfare of patients are ensured.

2.

Initiate such cost containment or other measures as are set forth in the appropriation act.

3.

Make, adopt, promulgate and enforce such regulations as may be necessary to carry out the provisions of this chapter.

4.

Examine, before acting on a regulation to be published in the Virginia Register of Regulations pursuant to § 2.2-4007.05, the potential fiscal impact of such regulation on local boards of social services.

For regulations with potential fiscal impact, the Board shall share copies of the fiscal impact analysis with local boards of social services prior to submission to the Registrar.

The fiscal impact analysis shall include the projected costs/savings to the local boards of social services to implement or comply with such regulation and, where applicable, sources of potential funds to implement or comply with such regulation.

5.

Incorporate sanctions and remedies for certified nursing facilities established by state law, in accordance with 42 C.F.R.

§ 488.400 et seq.

"Enforcement of Compliance for Long-Term Care Facilities With Deficiencies." 6.

On and after July 1, 2002, require that a prescription benefit card, health insurance benefit card, or other technology that complies with the requirements set forth in § 38.2-3407.4:2 be issued to each recipient of medical assistance services, and shall upon any changes in the required data elements set forth in subsection A of § 38.2-3407.4:2, either reissue the card or provide recipients such corrective information as may be required to electronically process a prescription claim.

InA order"major tobusiness enablefacility" theis Commonwealtha tocompany continuethat tosatisfies receive federal grants or reimbursement for medical assistance or related services, the Board,following subjectcriteria: to the approval of the Governor, may adopt, regardless of any other provision of this chapter, such amendments to the state plan for medical assistance services as may be necessary to conform such plan with amendments to the United States Social Security Act or other relevant federal law and their implementing regulations or constructions of these laws and regulations by courts of competent jurisdiction or the United States Secretary of Health and Human Services.

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.

However, the Board shall, pursuant to the requirements of § 2.2-4002, (i) notify the Registrar of Regulations that such amendment is necessary to meet the requirements of federal law or regulations or because of the order of any state or federal court, or (ii) certify to the Governor that the regulations are necessitated by an emergency situation.

Any such amendments that are in conflict with the Code of Virginia shall only remain in effect until July 1 following adjournment of the next regular session of the General Assembly unless enacted into law.

D.

The Director of Medical Assistance Services is authorized to:

AdministerSubject suchto statethe planprovisions andof receivesubsections andK expendor federalL, fundsthe thereforestablishment or expansion of the company shall result in accordancethe withcreation applicableof federalat andleast state50 lawsjobs andfor regulations;qualified full-time employees;

andthe enterfirst intosuch all50 contractsjobs necessaryshall orbe incidentalreferred to theas performance of the Department's"threshold dutiesamount"; and the execution of its powers as provided by law.

ofand 6 2.

EnterThe intocompany agreementsis andengaged contractsin withany medicalbusiness carein facilities,the physicians,Commonwealth, dentistsexcept anda otherretail healthtrade carebusiness providersif wheresuch necessarytrade tois carry out the provisionsprincipal activity of suchan stateindividual plan.facility in the Commonwealth.

AnyExamples suchof Igreementtypes orof contractmajor shallbusiness terminatefacilities uponthat convictionare eligible for the credit provided under this section include, but are not limited to, a headquarters, or portion of such a facility, where company employees are physically employed, and where the providermajority of the company's financial, personnel, legal or planning functions are handled either on a felony.regional or national basis.

InA company primarily engaged in the eventCommonwealth suchin convNctionthe isbusiness agreementof manufacturing or contract.mining;

Suchagriculture, providerforestry may also apply to the Director for reconsideration of ther a new agreement or contractfishing; termination if the conviction is not appealed, or if it is not reversed upon appeal.

3.transportation or communications;

Refuseor toa enterpublic intoutility orsubject renewto anthe agreementcorporation orincome contract,tax orshall electbe deemed to terminatehave anestablished existingRagreement or contract,expanded witha anymajor providerbusiness whofacility hasin beenthe convictedCommonwealth ofif orit otherwisemeets pledthe guiltyrequirements toof asubdivision felony,1 orduring pursuanta tosingle Subpartstaxable A,year B, and Csuch offacilities 42are C.F.R.not retail establishments.

PartA 1002,major andbusiness uponfacility noticeshall ofalso suchinclude actionfacilities tothat theperform providercentral management or administrative activities, whether operated as requireda byseparate 42trade C.F.R.or business, or as a separate support operation of another business.

§Central 1002.212.management or administrative activities include, but are not limited to, general management;

Daccounting; 4.

Refusecomputing; to enter into or renew an agreement or contract, or elect to terminate an existing agreement 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.

Parttabulating; 1002.

Epurchasing; 5.

Terminatetransportation or suspendshipping; a provider agreement with a home care organization pursuant to subsection E of § 32.1-162.13.

Dengineering Forand thesystems purposesplanning; of this subsection, "provider" may refer to an individual or an entity.

advertising;

technical sales and support operations;

central administrative offices and warehouses;

research, development and testing laboratories;

computer-programming, data-processing and other computer-related services facilities;

and legal, financial, insurance, and real estate services.

The terms used in this subdivision to refer to various types of businesses shall have the same meanings as those terms are commonly defined in the Standard Industrial Classification Manual.

D.

For purposes of this section, the "credit year" is the first taxable year following the taxable year in which the major business facility commenced or expanded operations.

InThe anyDepartment caseof inTaxation whichshall amake Medicaidall agreementdeterminations oras contract is terminated or denied to athe providerclassification §of 1002.213 and to a post-determinationmajor orbusiness post-denialfacility hearing in accordance with the AdministrativeR.provisions of this section.

ProcessF. Act (§ 2.2-4000 et seq.).

AllA such"qualified requestsfull-time shallemployee" bemeans inan writingemployee andfilling bea receivednew, withinpermanent 15full-time daysposition ofin thea datemajor ofbusiness receiptfacility ofin the notice.Commonwealth.

TheA Director"new, maypermanent considerfull-time aggravatingposition" andis mitigatinga factorsjob includingof an indefinite duration, created by the naturecompany andas extenta result of anythe adverseestablishment impactor expansion of a major business facility in the agreementCommonwealth, orrequiring contracta denialminimum of 35 hours of an employee's time a week for the entire normal year of the company's operations, which "normal year" shall consist of at least 48 weeks, or terminationa mayposition haveof onindefinite duration which requires a minimum of 35 hours of an employee's time a week for the medicalportion careof proHidedthe totaxable Virginiayear Medicaidin recipients.which the employee was initially hired for, or transferred to, the major business facility in the Commonwealth.

InSeasonal casesor intemporary whichpositions, anor agreementa orjob contractcreated when a job function is terminatedshifted pursu6ntfrom toan subsectionexisting D,location in the DirectorCommonwealth mayto determine the periodnew ofmajor exclusionbusiness facility and maypositions considerin aggravatingbuilding a0dand grounds maintenance, security, and other such positions which are ancillary to 42the C.F.R.principal activities performed by the employees at a major business facility shall not qualify as new, permanent full-time positions.

§ 1002.215.ngthen or shorten the period of exclusion, and may reinstate the provider pursuant F.

When 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 social workers, licensed professional counselors and licensed clinical nurse specialists at rates basedical upon reasonable criteria, including the professional credentials required for licensure.

TheFor Boardany shallmajor preparebusiness andfacility, submit to the Secretaryamount of thecredit Unitedearned Statespursuant Department of Health and Human Services such amendments to thethis statesection planshall for medical assistance services as may be permittedequal by federal law to establish$1,000 aper programqualified offull-time familyemployee, assistance whereby children over the agethreshold ofamount, 18employed yearsduring shall make reasonable contributions, as determined by regulations of the Board,credit towardyear. the cost of providing medical assistance under the plan to their parents.

of 3 The credit shall be allowed ratably, with one-third of the credit amount allowed annually for three years beginning with the credit year.

However, for taxable years beginning on or after January 1, 2009, one-half of the credit amount shall be allowed each year for two years.

The portion of the $1,000 credit earned with respect to any qualified full-time employee who is employed in the Commonwealth for less than 12 full months during the credit year will be determined by multiplying the credit amount by a fraction, the numerator of which is the number of full months that the qualified full-time employee worked for the major business facility in the Commonwealth during the credit year, and the denominator of which is 12.

A separate credit year and a three-year allowance period shall exist for each distinct major business facility of a single taxpayer, except for credits allowed for taxable years beginning on or after January 1, 2009, when a two-year allowance period shall exist for each distinct major business facility of a single taxpayer.

H.

The amount of credit allowed pursuant to this section shall not exceed the tax imposed for such taxable year.

Any credit not usable for the taxable year the credit was allowed may be, to the extent usable, carried over for the next 10 succeeding taxable years.

No credit shall be carried back to a preceding taxable year.

In the event that a taxpayer who is subject to the tax limitation imposed pursuant to this subsection is allowed another credit pursuant to any other section of the Code of Virginia, or has a credit carryover from a preceding taxable year, such taxpayer shall be considered to have first utilized any credit allowed which does not have a carryover provision, and then any credit which is carried forward from a preceding taxable year, prior to the utilization of any credit allowed pursuant to this section.

I.

No credit shall be earned pursuant to this section for any employee (i) for whom a credit under this section was previously earned by a related party as defined by Internal Revenue Code § 267(b) or a trade or business under common control as defined by Internal Revenue Code § 52(b);

(ii) who was previously employed in the same job function in Virginia by a related party as defined by Internal Revenue Code § 267(b) or a trade or business under common control as defined by Internal Revenue Code § 52(b);

(iii) whose job function was previously performed at a different location in Virginia by an employee of the taxpayer, a related party as defined by Internal Revenue Code § 267(b), or a trade or business under common control as defined by Internal Revenue Code § 52(b);

or (iv) whose job function previously qualified for a credit under this section at a different major business facility on behalf of the taxpayer, a related party as defined by Internal Revenue Code § 267(b), or a trade or business under common control as defined by Internal Revenue Code § 52(b).

J.

Subject to the provisions of subsections K or L, recapture of this credit, under the following circumstances, shall be accomplished by increasing the tax in any of the five years succeeding the taxable year in which a credit has been earned pursuant to this section if the number of qualified full-time employees decreases below the average number of qualified full-time employees employed during the credit year.

Such tax increase amount shall be determined by (i) recomputing the credit which would have been earned for the original credit year using the decreased number of qualified full-time employees and (ii) subtracting such recomputed credit from the amount of credit previously earned.

In the event that the average number of qualifying full-time employees employed at a major business facility falls below the threshold amount in any of the five taxable years succeeding the credit year, all credits earned with respect to such major business facility shall be recaptured.

No credit amount will be recaptured more than once pursuant to this subsection.

Any recapture pursuant to this section shall reduce credits earned but not yet allowed, and credits allowed but carried forward, before the taxpayer's tax liability may be increased.

K.

In the event that a major business facility is located in an economically distressed area or in an enterprise zone as defined in Chapter 49 (§ 59.1-538 et seq.) of Title 59.1 during a credit year, the threshold amount required to qualify for a credit pursuant to this section and to avoid full recapture shall be reduced from 50 to 25 for purposes of subdivision C 1 and subsection J.

An area shall qualify as economically distressed if it is a city or county with an unemployment rate for the preceding year of at least 0.5 percent higher than the average statewide unemployment rate for such year.

The Virginia Economic Development Partnership shall identify and publish a list of all economically distressed areas at least annually.

L.

For taxable years beginning on or after January 1, 2004, but before January 1, 2006, in the event that a major business facility is located in a severely economically distressed area, the threshold amount required to qualify for a credit pursuant to this section and to avoid full recapture shall be reduced from to 25 for purposes of subdivision C 1 and subsection J.

However, the total amount of credit allowable under this subsection shall not exceed $100,000 in aggregate.

An area shall qualify as severely economically distressed if it is a city or county with an unemployment rate for the preceding year of at least twice the average statewide unemployment rate for such year.

The Virginia Economic Development Partnership shall identify and publish a list of all severely economically distressed areas at least annually.

M.

The Tax Commissioner shall promulgate regulations, in accordance with the Administrative Process Act (§ 2.2-4000 et seq.), relating to (i) the computation, carryover, and recapture of the credit provided under this section;

(ii) defining criteria for (a) a major business facility, (b) qualifying full-time of 3 employees at such facility, and (c) economically distressed areas;

and (iii) the computation, carryover, recapture, and redemption of the credit by affiliated companies pursuant to subsection S.

N.

The provisions of this section shall apply only in instances where an announcement of intent to establish or expand a major business facility is made on or after January 1, 1994.

An announcement of intent to establish or expand a major business facility includes, but is not limited to, a press conference or extensive press coverage, providing information with respect to the impact of the project on the economy of the area where the major business facility is to be established or expanded and the Commonwealth as a whole.

O.

The credit allowed pursuant to this section shall be granted to the person who pays taxes for the qualified full-time employees pursuant to Chapter 5 (§ 60.2-500 et seq.) of Title 60.2.

P.

No person shall claim a credit allowed pursuant to this section and the credit allowed pursuant to § 58.1-439.2.

Any qualified business firm receiving an enterprise zone job creation grant under § 59.1-547 shall not be eligible to receive a major business facility job tax credit pursuant to this section for any job used to qualify for the enterprise zone job creation grant.

Q.

No person operating a business in the Commonwealth pursuant to Chapter 29 (§ 59.1-364 et seq.) of Title 59.1 shall claim a credit pursuant to this section.

R.

Notwithstanding subsection O, a taxpayer may, for the purpose of determining the number of qualified full-time employees at a major business facility, include the employees of a contractor or a subcontractor if such employees are permanently assigned to the taxpayer's major business facility.

If the taxpayer includes the employees of a contractor or subcontractor in its total of qualified full-time employees, it shall enter into a contractual agreement with the contractor or subcontractor prohibiting the contractor or subcontractor from also claiming these employees in order to receive a credit given under this section.

The taxpayer shall provide evidence satisfactory to the Department of Taxation that it has entered into such a contract.

S.

For purposes of satisfying the criteria of subdivision C 1, two or more affiliated companies may elect to aggregate the number of jobs created for qualified full-time employees as the result of the establishment or expansion by the individual companies in order to qualify for the credit allowed pursuant to this section.

For purposes of this subsection, "affiliated companies" means two or more companies related to each other such that (i) one company owns at least 80 percent of the voting power of the other or others or (ii) at least 80 percent of the voting power of two or more companies is owned by the same interests.

T.

The General Assembly of Virginia finds that modern business infrastructure allows businesses to locate their administrative or manufacturing facilities with minimal regard to the location of markets or the transportation of raw materials and finished goods, and that the economic vitality of the Commonwealth would be enhanced if such facilities were established in Virginia.

Accordingly, the provisions of this section targeting the credit to major business facilities and limiting the credit to those companies which establish a major business facility in Virginia are integral to the purpose of the credit earned pursuant to this section and shall not be deemed severable.

U.

For taxable years beginning on and after January 1, 2019, and notwithstanding the provisions of § 58.1-3 or any other provision of law, the Department of Taxation, in consultation with the Virginia Economic Development Partnership, shall publish the following information by November 1 of each year for the 12-month period ending on the preceding December 31:

IncludeThe inlocation its provider networks and all of itssites healthused maintenance organization contracts a provision for themajor paymentbusiness offacilities 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 neglect, or a providercredit withwas comparableclaimed; expertise, as determined by the Director.

AmendThe theNorth MedallionAmerican IIIndustry waiverClassification andSystem itscodes implementingused regulationsfor to develop and implement an age three certified by the Departmentmajor ofbusiness Behavioralfacilities Healthfor andwhich Developmentala Servicescredit aswas eligibleclaimed; fornd services pursuant to Part C of the Individuals with Disabilities Education Act (20 U.S.C.

§ 1471 et seq.).

Utilize,The tonumber theof extentqualified practicable,full electronictime fundsemployees transfer technology for reimbursementwhom toa contractorscredit andwas enrolledclaimed; providers for the provision of health care services under Medicaid and the Family Access to Medical Insurance Security Plan established under § 32.1-351.

and 4.

RequireThe anytotal managedcost care organization with which the Department enters into an agreement for the provision of medical assistance services to include in any contract between the managedCommonwealth's caregeneral afund representative of the pharmacycredits benefitsclaimed. manager from conducting spread pricing with regards to the HB680 6 of 6 managed care organization's managed care plans.

ForSuch information shall be published by the purposesDepartment, regardless of thishow subdivision:few taxpayers claimed the tax credit, in a manner that prevents the identification of particular taxpayers, reports, returns, or items.

"Pharmacy benefits management" means the administration or management of prescription drug benefits provided by a managed care organization for the benefit of covered individuals.

"Pharmacy benefits manager" means a person that performs pharmacy benefits management.

"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.

I.

The Director is authorized to negotiate and enter into agreements for services rendered to eligible recipients with special needs.

The Board shall promulgate regulations regarding these special needs patients, to include persons with AIDS, ventilator-dependent patients, and other recipients with special needs as defined by the Board.

J.

Except as provided in subdivision A 1 of § 2.2-4345, the provisions of the Virginia Public Procurement Act (§ 2.2-4300 et seq.) shall not apply to the activities of the Director authorized by subsection I of this section.

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