Summary: State plan for medical assistance services and health insurance; pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome. Directs the Board of Medical Assistance Services to amend the state plan for medical assistance services to include a provision for payment of medical assistance for the prophylaxis, diagnosis, and treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS) that includes payment for treatment using antimicrobials, medication and behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy.The bill also requires each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services to provide coverage for the prophylaxis, diagnosis, and treatment of PANDAS and PANS. The bill requires such coverage to include coverage for treatment using antibiotics, medication, and behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy.The bill prohibits an insurer, corporation, or organization from (i) denying or delaying the coverage of PANDAS or PANS because the enrollee previously received treatment or because the enrollee was diagnosed with or received treatment for his condition under a different diagnostic name, including autoimmune encephalopathy; (ii) limiting coverage of immunomodulating therapies for the treatment of PANDAS or PANS in a manner that is inconsistent with the treatment guidelines developed by a consortium convened for the purposes of researching, identifying, and publishing best practice standards for diagnosis and treatment of PANDAS or PANS that are accessible for medical professionals and are based on evidence of positive patient outcomes; (iii) requiring a trial of therapies that treat only neuropsychiatric symptoms before authorizing coverage of immunomodulating therapies for the treatment of PANDAS or PANS; or (iv) denying coverage for out-of-state treatment if the service is not available within the Commonwealth.

Summary: Long-term services and supports screening; expedited screening; screening exemption; emergency. Modifies existing provisions regarding the required long-term services and supports screening under the state plan for medical assistance services by creating greater flexibility for how screenings are completed under certain circumstances. Under the bill, any individual receiving inpatient services in an acute care hospital discharged to a nursing facility for skilled care only is not required to be screened prior to discharge from the hospital unless the individual requests the screening. The bill directs the Department of Medical Assistance Services to adopt emergency regulations to implement the provisions of the bill. This bill is identical to SB 24 and contains an emergency clause.

Summary: Department of Health; emergency regulationsrelated to prescription drug price transparency; effective period; emergency. Directs that the emergency regulations 12VAC5-219,promulgated by the Department of Health pursuant to Chapter 304 ofthe Acts of Assembly of 2021, Special Session I, shall remain in effect until the promulgation of final regulations. The bill requiressuch effective period to be retroactive to January 1, 2024, and contains an emergency clause.

Summary: Long-term services and support screening; PACE programs; emergency. Allows qualified staff of programs of all-inclusive care for the elderly (PACE) to conduct the required long-term services and supports screening in accordance with requirements established by the Department of Medical Assistance Services. Under the bill, when a screening team determines that it is unable to complete a long-term services and supports screening within 30 days, or an individual requests enrollment in a PACE program, the screening team shall decide which entity can most expeditiously conduct the screening. Under the bill, qualified staff of a PACE program shall conduct the screening if the screening team determines that it is the most expeditious option. The bill directs the Department to adopt emergency regulations to implement the provisions of the bill and contains an emergency clause. This bill is identical to SB 620.