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State Legislation Relating to Health Care

Elimination of the "All Products" Clause:

This bill states that "a provider panel contract... shall contain a provision permitting the provider to refuse participation in one or more such provider panels at the time the contract is executed without affecting the provider's status as a member of or for eligibility in other existing or new provider panels..." Signed by the Governor

Virginia Health Information (VHI) Data Reporting:

Legislation passed both houses to allow VHI to select reportable procedures for licensed ambulatory surgery centers and physician's offices from those surgical procedures that require general anesthesia. Dr. Alan Terlinsky testified in the Senate hearing contending that "this would be an invasion of patient privacy, as well as, an added burden to physicians' practices." Vetoed by the Governor

Nurse Practitioner Prescriptive Authority:

The bill provides for a phase-in of prescriptive authority for nurse practitioners as follows: (i) schedules V and VI controlled substances on and after July 1, 2000,; (ii) Schedules IV-VI on and after January 1, 2002; and (iii) Schedules III-VI controlled substances on and after July 1, 2003.

The bill requires regulations to be promulgated that may include at a minimum continuing education, testing, and/or any other requirement, and shall address the need to promote ethical practice, an appropriate standard of care, patient safety, and the use of new pharmaceuticals, and appropriate communication with patients. The Medical Society of Virginia and ACMS argued in opposition to the increase in prescriptive authority and were appeased with the compromise of continuing education. Signed by the Governor

Health Plan Medical Director Licensure:

This bill introduces language that a physician is to be licensed to practice medicine in the Commonwealth of Virginia who is an employee of a utilization review organization and responsible for compliance with the provisions of this article. Signed by the Governor.

Repeal of the Certificate of Public Need (COPN):

This bill requires the Joint Commission of Health Care to devise an implementation plan to be presented to the 2001 General Assembly. Upon approval of the plan, the COPN phase out will begin in July 2001 and is to be completed by July 2004. The writing of the plan will be a complex undertaking because the Joint Commission on Health Care must consider the following components: 1) meeting the health care needs of the indigent including access to care and provision of all health care providers to share in meeting such needs; 2) meeting the health care needs of the uninsured citizens of the Commonwealth, including access to care; 3) establishing licensure standards for the various deregulated services; 4) providing adequate oversight of the various deregulated services to protect the public health and safety; 5) providing for monitoring the effects of deregulation during the transition period and after full implementation of this section on the number and location of medical facilities and projects; 6) determining the effect of deregulation on long term care facilities and new hospitals,;7) determining the effect of deregulation on the unique mission of academic medical centers; 8) determining the effect of deregulation on rural hospitals which are critical access hospitals; 9) recommending a schedule for necessary statutory changes to implement the plan and for requiring, subject to approval of the General Assembly, that the appropriate regulatory boards promulgate regulations implementing the Commission's plan prior to any deregulation recommended in the plan.

The bill in its final form was supported by the Virginia Hospital and Health Care Association. Signed by the Governor.

Peer Review Privilege Decision Explained

The Supreme Court of Virginia held on Friday, June 9, 2000 that:

1. the peer review privilege is not restricted to medical malpractice cases
2. the peer review privilege does not belong to, nor can it be waived, by the target of peer review activity
3. the need to establish a defense in a civil action does not rise to the level of "good cause arising from extraordinary circumstances" necessary to overcome the privilege.

The MSV has summarized the decision in the Levin cases. Click here for the summary.