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2019 SESSION
19102202DBe 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.
[ A. ] 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 [ or its contractor
] . Documentation of such rejection
shall be included in the patient's medical record.
[ B. Every provider who does not accept payment
from the Department of Medical Assistance Services for health care services and
provides health care services described in subsection A to a patient who is a
recipient of medical assistance services pursuant to the state plan for medical
assistance shall provide notice to such patient that (i) the Commonwealth's
program of medical assistance services covers the health care services
described in subsection A and the Department of Medical Assistance Services will
pay for such health care services and (ii) the provider does not participate in
the Commonwealth's program of medical assistance and will not accept payment
from the Department of Medical Assistance Services for such health care
services. Such notice and the patient's acknowledgment of such notice shall be
documented in the patient's medical record. ]