GOVERNOR'S VETO

Pursuant to § 6 of Article V of the Constitution of Virginia, I veto House Bill 2567.

House Bill 2567, as introduced, sought to require the Department of Medical Assistance Services (DMAS) to cover high-dose chemotherapy and bone marrow transplants for individuals who have been diagnosed with leukemia.

I agree with the original language of House Bill 2567. However, in the closing days of the Session, the General Assembly amended the legislation by adding language that has nothing to do with the treatment of leukemia. The amending language seeks to dramatically rewrite the Virginia Administrative Process Act (APA) as relates to appeals of DMAS decisions regarding reimbursement of health care providers in all cases. The new language would allow providers to bypass the current procedures of the APA and to seek a de novo trial in circuit court, including the right to trial by jury, rendering the normal appeals process in the reimbursement cases a nullity.

The bill also creates an incentive for health care providers to file suit in reimbursement cases by authorizing the health care provider to recover unlimited attorneys' fees and costs.

Much of what determines the level of Medicaid reimbursement to health care providers is based on a combination of both state and federal law and regulations.

If the bill as passed were permitted to become law, I am advised that its administration would significantly increase the workload of the circuit courts, and attorneys representing DMAS, and likely require additional personnel and resources to handle the increased caseload. In 1998, the Department of Medical Assistance Services alone received 265 requests for appeals under the provisions of current law.

I am concerned that diverse case law decisions among the different circuit courts in this complex area of the law would lead to uncertainty in the law for both health care providers and the Commonwealth as to appropriate levels of reimbursements, creating even more litigation. The current system of administrative case decisions under the Administrative Process Act provides for uniform guidance for those who seek reimbursement and those who provide it.

I simply cannot justify compromising the integrity of the complex Medicaid reimbursement process nor the significant increase in cost to taxpayers.

The original intent of House Bill 2567, which I support, would provide for coverage by Medicaid for high-dose chemotherapy and bone marrow transplants for the treatment of leukemia, has been included in the 1999 Appropriation Act [Paragraph DD of Item 335] which I have already signed into law.

Accordingly, I am returning House Bill 2567 without my signature.

GOVERNOR'S RECOMMENDATION

1. That the Amendment in the Nature of a Substitute (999197811) be accepted.