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SB1167

Medicaid recipients; treatment involving opioids or opioid replacements, coverage of health care.

https://lis.virginia.gov/cgi-bin/legp604.exe?191+sum+SB1167

Medicaid recipients; treatment involving opioids or opioid replacements; payment. ;Prohibits health care providers licensed by the Board of Medicine from requesting or requiring a patient who is a recipient of medical assistance services pursuant to the state plan for medical assistance to whom health care services involving (i) the prescription of an opioid for the management of pain or (ii) the prescription of buprenorphine-containing products, methadone, or other opioid replacements approved for the treatment of opioid addiction by the U.S. Food and Drug Administration for medication-assisted treatment of opioid addiction are provided to pay costs associated with the provision of such service out-of-pocket, unless such provider has received (a) a rejection of prior authorization, (b) a rejection of a submitted claim, or (c) a written denial of reimbursement for such service from the Department of Medical Assistance Services (DMAS). The bill also ;requires ;every provider ;who does not accept payment from ;DMAS for health care services and provides certain ;health care services ;to a patient who is a recipient of medical assistance services ;to provide notice to ;the patient that (1) the Commonwealth';s program of medical assistance services covers the health care services and DMAS will pay for ;the health care services and (2) the provider does not participate in the Commonwealth';s program of medical assistance and will not accept payment from ;DMAS for ;the health care services.


Chafin
Reported with Substitute

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