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2019 SESSION

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19102202D
SENATE BILL NO. 1167 Offered January 9, 2019 Prefiled January 3, 2019 A BILL to amend the Code of Virginia by adding a section numbered 54.1-2910.3:1, relating to Medicaid recipients; treatment involving opioids; payment. ---------- Patron-- Chafin ---------- Referred to Committee on Education and Health ----------

Be it enacted by the General Assembly of Virginia:

1. That the Code of Virginia is amended by adding a section numbered 54.1-2910.3:1 as follows:

§ 54.1-2910.3:1. Medicaid recipients; treatment involving prescription of opioids; payment.

No provider licensed pursuant to this chapter shall request or require a patient who is a recipient of medical assistance services pursuant to the state plan for medical assistance and who is a recipient of 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 to pay costs associated with the provision of such service out-of-pocket, unless such provider has received a rejection of prior authorization, a rejection of a submitted claim, or a written denial of reimbursement for such service from the Department of Medical Assistance Services. Documentation of such rejection shall be included in the patient's medical record.