Virginia Emergency Medicine Legislative Update: January 26, 2019

Next week, starting January 28, will be busy and chaotic at the General Assembly. It is the last week before Crossover – the halfway point when both the House and Senate must complete debate on their bills and pass to the other chamber. After Crossover, the bills that passed one chamber then move to the other and go through the committee process on that side. Things will move very quickly and our biggest priority, surprise billing, will be addressed in both the House and the Senate next week.

Here is the legislation being tracked by the Virginia College of Emergency Physicians and our lobbying team.

Surprise Billing and Out-of-Network Care

There are several bills dealing with the issue of surprise/balance billing. Some of the bills focus on the emergency services piece and some are only elective or ancillary services. VACEP strongly supports Delegate Ware’s HB1714 and Senator Sturtevant’s SB1763. These bills prohibit balance billing for emergency services, but ensure that physicians receive a fair and reasonable, direct payment from the health plan. They also include critical language strengthening the prudent layaperson standard. We are actively working against other bills that would simply ban balance billing and not provide for a fair payment. The House bills will be heard in the House Commerce and Labor committee next Thursday. We anticipate the Senate bills will be heard in an extra Commerce and Labor committee at the end of the week.

Here are the bills, and where we stand on them.

  • HB1714 (Ware): Balance billing; emergency services; SUPPORT
  • HB2544 (Byron): Balance billing for emergency services; OPPOSE
  • HB2538 (Ware): Balance billing for elective services; NEEDS AMENDMENTS
  • HB2543 (Byron): Balance billing for ancillary services; NEEDS AMENDMENTS
  • SB1763 (Sturtevant): Balance billing; emergency services; SUPPORT
  • SB1360 (Wagner): Balance billing, emergency services; OPPOSE
  • SB1362 (Wagner): Balance billing for ancillary services; NEEDS AMENDMENTS
  •  SB1354 (McDougle): Balance billing; emergency and elective services; NEEDS AMENDMENTS
  •  SB1228 (Chase): Payment to out-of-network providers, emergency services; NEEDS AMENDMENTS

HB2530 (Head): Medicaid; Cost-sharing

VACEP position: Opposed

This bill would have required hospitals to develop a protocol to tell Medicaid patients who come to the ED the potential cost of the visit and if they can be served somewhere else- a dangerous suggestion that would surely run afoul of EMTALA.  In addition, it would require Medicaid recipients to pay a co-payment if their visit was determined to have been non-emergent after the fact. We oppose this bill because programs like this only hurt the patient and are not proven to change behavior. Rather, such policies can deter a patient from seeking what may be critical, life-saving medical care. Our lobbyist testified against this bill in its subcommittee hearing this week. The subcommittee did not take a vote at that time. Based on our conversations with other subcommittee members, there were a lot of concerns and we do not expect this bill to pass.


HB2267 (Poindexter): Hospitals; Drawing of certain blood samples

VACEP position: Concerned

This bill would have required hospitals to collect blood samples from patients who are unwilling or unable to provide consent when such samples are required by a valid search warrant. Several groups, including VACEP, had concerns about the bill. As a result, the patron requested the bill be stricken and it will not move forward.


SB1439 (McClellan): Death certificates; electronic filing

VACEP position: Closely monitoring

This bill will require the medical certification portion of a death certificate to be filed electronically through the Electronic Death Registration System beginning January 1, 2020. Failure to file the certificate electronically is grounds for disciplinary action by the Board of Medicine.  It passed the Senate floor unanimously and will be next heard in the House Health, Welfare and Institutions committee.


SB1395 (Howell): Health care provider; threats of death or bodily injury

VACEP position: Support

This bill would make verbal assault or threats against a health care provider a Class 1 misdemeanor (battery against a health care provider is currently. The bill had opposition in committee, but ended up passing the Senate floor 28-12.