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2014 SPECIAL SESSION I

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Senate Committee on Commerce and Labor

Chairman: John C. Watkins

Staff: Frank Munyan
Date of Meeting: November 10, 2014
Time and Place: 3PM / Senate Room B
Updated on 11/9/2014

S.B. 5006 Medicaid; regional care organizations.

Patron: Stanley

Medicaid; regional care organizations. Directs the Department of Medical Assistance Services (Department), subject to approval of the federal Centers for Medicare and Medicaid Services, to enter into contracts in regions of the Commonwealth with a regional care organization (RCO). Under the contracts, an RCO will provide medical care to Medicaid beneficiaries and receive capitated payments from the Department. The Department is required to enroll a majority of the Commonwealth's Medicaid beneficiaries into RCOs. An RCO may contract with any willing health care provider to provide services in a Medicaid region if the provider is willing to accept the payments and terms offered to comparable providers. In order to be certified as an RCO, an organization is required to be certified by the Department as meeting eligibility requirements, including financial standards and service delivery network requirements.

A BILL to amend the Code of Virginia by adding in Title 32.1 a chapter numbered 17, consisting of sections numbered 32.1-370 through 32.1-382, relating to the delivery of health care services to Medicaid beneficiaries through regional care organizations.

14200439D

S.B. 5007 Medicaid; accountable care organizations.

Patron: Stanley

Medicaid; accountable care organizations. Directs the Department of Medical Assistance Services (Department) to establish a health care delivery system under which a majority of the Commonwealth's Medicaid beneficiaries will receive benefits through accountable care organizations (ACOs). ACOs are corporations that provide health care services through their member health care providers and receive Medicaid payments through innovative payment methodologies, which include capitated payments, gainsharing payment arrangements, pay-for-performance, quality-based payments, and other payment arrangements to generate savings from greater coordination and efficiency in service delivery. A portion of these cost savings are to be distributed among the health care providers participating in the ACO. Prior to contracting with the Department, a proposed ACO shall obtain a certification of authority issued by the State Corporation Commission (Commission), which can be issued if the ACO satisfies requirements regarding working capital and reserves. The Commission and the Attorney General are further required to determine (i) whether a proposed ACO is likely to reduce competition in a market for health care services and (ii) that the ACO's pro-competitive benefits are likely to substantially outweigh the anticompetitive effects of any increase in market power. The Department is directed to apply for federal waivers required for implementation of the program.

A BILL to amend the Code of Virginia by adding sections numbered 2.2-515.3 and 2.2-515.4, to amend the Code of Virginia by adding in Title 32.1 a chapter numbered 17, consisting of sections numbered 32.1-370 through 32.1-391, and to amend the Code of Virginia by adding in Title 38.2 a chapter numbered 64, consisting of sections numbered 38.2-6400 through 38.2-6411, relating to the establishment of Medicaid accountable care organizations.

14200441D

S.B. 5009 Health insurance exchanges, private; registration and operation.

Patron: Stanley

Private health insurance exchanges. Provides that one or more private entities may establish private health insurance exchanges within the Commonwealth. The measure requires exchanges to be registered with the State Corporation Commission. Participating employers may elect to purchase health benefit plans for their eligible employees and their dependents from a participating health carrier. Alternatively, a participating employer may authorize its eligible employees to purchase a health benefit plan directly from a participating health carrier using funds provided by the employer, and the employee may use the employee's own funds to supplement the level of coverage that the employer's contribution would cover. A SHOP exchange operating in Virginia under the federal Patient Protection and Affordable Care Act would be exempt from the requirements established by this measure.

A BILL to amend the Code of Virginia by adding in Title 38.2 a chapter numbered 64, consisting of sections numbered 38.2-6400 through 38.2-6427, relating to the registration and operation of private health insurance exchanges in the Commonwealth; penalties.

14200443D

S.B. 5012 Health benefit plans; renewal of nonconforming policies.

Patrons: Barker, Saslaw

Health benefit plans; renewal of nonconforming polices. Authorizes health carriers to offer to renew any health benefit plan that would otherwise be required to be canceled, discontinued, or terminated because it does not meet the requirements of the federal Patient Protection and Affordable Care Act, to the extent and under the terms that the appropriate federal authority has suspended enforcement of provisions of such Act. The measure has an emergency clause.

A BILL to amend the Code of Virginia by adding in Article 6 of Chapter 34 of Title 38.2 a section numbered 38.2-3454.1, relating to renewals of certain health benefit plans.

14200549D

EMERGENCY

S.B. 5014 Health benefit plans; renewal of nonconforming policies.

Patron: Norment

Health benefit plans; renewal of nonconforming polices. Authorizes health carriers to offer to renew any health benefit plan that would otherwise be required to be canceled, discontinued, or terminated because it does not meet the requirements of the federal Patient Protection and Affordable Care Act, to the extent and under the terms that the appropriate federal authority has suspended enforcement of provisions of such Act. The measure has an emergency clause.

A BILL to amend the Code of Virginia by adding in Article 6 of Chapter 34 of Title 38.2 a section numbered 38.2-3454.1, relating to renewals of certain health benefit plans.

14200651D

EMERGENCY