2008 General Assembly Update
The 2008 General Assembly adjourned five days late as Budget Conferees negotiated final details of a $77 billion biennial budget.  This process was, at times, contentious as the House and Senate argued over how to overcome a $1.4 billion shortfall attributed to slumping economy.  Neither the Governor’s proposed budget nor the final package included physician Medicaid cuts; something that hospitals and nursing homes did not avoid.

We were fortunate that the Society did not face any scope of practice battles this year.  Instead, our efforts were focused on assisting the Medical Society of Virginia and other specialty societies on broader legislation affecting the practice of medicine.  Several areas of interest are outlined below.  Please contact our lobbyist, Cal Whitehead, at cwhitehead@whiteheadconsulting.net if you would like information about any of these issues.

Thanks to all Society members who participated in MSV “White Coats on Call”, placed calls or sent emails to legislators, or who made in-district visits to Delegates and Senators. 

Professional Liability
Legislation was adopted that will define "professional services" in the context of medical malpractice and enhance physician immunity and liability protections in certain situations.  These companion bills were HB 501 (Hamilton, R-Newport News) and SB 602 (Norment, R-Williamsburg).

HB 403 (Hamilton, R-Newport News) and SB 657 (Newman, R-Lynchburg), two bills to expand physician immunity during disaster situations, easily passed the General Assembly.  Likewise, the “Good Samaritan Law” was strengthened by HB 1294 (Athey, R-Winchester), which would extend immunity protections to physicians who provide care at a location for screening or stabilization in addition to the scene of the accident and en route to the hospital, clarify that reimbursement for expenses is not considered compensation under the statute.

SB 211 (Edwards, D- Roanoke) and HB 1305 (Morgan, R-Gloucester), the Birth Injury Fund bills will improve the actuarial soundness of the Fund.  BIF is a critical component of protecting Virginia’s medical malpractice cap, which matures in July 2008.

Certificate of Public Need
The session included the usual number of COPN bills attempting to exempt certain technologies or facilities from the process and others that were designed to marginally reform or streamline certification.  Perennial COPN reformers, Delegates Phil Hamilton (R-Newport News) and John O’Bannon MD (R-Henrico), introduced legislation.  Hamilton’s bill, which was originally designed to give preference to applications when offered in a market-dominated planning area, was watered down significantly before passage.  O’Bannon’s attempt to exempt a single, Richmond cardiology practice’s application for a CT scanner was defeated in committee.  The hospital community continues to demonstrate that maintenance of COPN is a top priority.

Allied Health Professionals
SB 693 (Edwards, D-Roanoke) will allow a physician assistant to establish a final diagnosis or treatment plan for a patient as long as doing so is set forth in the written physician supervision agreement.

HB 383 (O’Bannon, R-Henrico) and SB 134 (Houck, D-Spotsylvania) establishes requirement of a license to practice as an occupational therapy assistant.  It is a similar structure to regulation of physical therapy assistants.

The physician community’s concerns led to the defeat of HB 784 (Kilgore, R-Gate City). This bill would have licensed the practice of Naturopathic doctors and allowed diagnosis and treatment of a wide range of diseases and conditions.

Mental Health Reform
The General Assembly committed nearly $42 million in new funding to implement laws that change involuntary commitment standards for mentally ill.  The changes also enhance accountability of community service boards (CSBs) in temporary detention and commitment hearings.  These changes were in reaction the April 16, 2007 shootings at Virginia Tech.  Additional mental health system reform will continue through several study commissions.

Public Health
Twelve smoke-free air bills were introduced and failed in the General Assembly this year. The Medical Society of Virginia, primary care specialties, and other stakeholders support Governor Tim Kaine’s efforts.  All of the smoke free air bills that were introduced in the Senate were passed in the full Senate and passed by the largest margins since smoke free air legislation was introduced in Virginia.

Cal Whitehead
cwhitehead@whiteheadconsulting.net