HB 601 Health insurance; mandated coverage for treatment of inborn errors of metabolism.

Chief patron: Murphy

Summary as introduced:
Health insurance; mandated coverage for treatment of inborn errors of metabolism. Requires health carriers to provide coverage for treatment of inborn errors of metabolism that involve amino acid, carbohydrate, and fat metabolism and for which medically standard methods of diagnosis, treatment, and monitoring exist. Coverage required pursuant to the bill shall include expenses of diagnosing, monitoring and controlling the disorders by nutritional and medical assessment, including clinical visits, biochemical analysis, medical foods, nutritional supplements, and formulas used in the treatment of such disorders.

01/11/16 House: Prefiled and ordered printed; offered 01/13/16 16102306D
01/11/16 House: Referred to Committee on Commerce and Labor
01/21/16 House: Impact statement from SCC (HB601)
01/26/16 House: Continued to 2017 in Commerce and Labor
12/01/16 House: Left in Commerce and Labor

HB 978 Health insurance; proton radiation therapy coverage decisions.

Chief patron: Yancey

Summary as introduced:
Health insurance; proton radiation therapy coverage decisions. Prohibits health insurance policies and plans from holding proton radiation therapy to a higher standard of clinical evidence for benefit coverage decisions than is applied for other types of radiation therapy treatment. The measure applies to policies and plans that provide coverage for cancer therapy.

01/19/16 House: Assigned C & L sub: Subcommittee #1
01/22/16 House: Impact statement from SCC (HB978)
01/26/16 House: Subcommittee recommends continuing to 2017
01/28/16 House: Continued to 2017 in Commerce and Labor
12/01/16 House: Left in Commerce and Labor

HB 1251 Health insurance; assignment of benefits.

Chief patron: Leftwich

Summary as introduced:

Health insurance; assignment of benefits. Prohibits health care coverage plan providers from refusing to accept assignments of benefits executed by covered individuals in favor of health care providers and hospitals. The bill is applicable to (i) insurers issuing individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis, (ii) corporations providing individual or group accident and sickness subscription contracts, (iii) health maintenance organizations providing health care plans for health care services, and (iv) dental services plans offering or administering prepaid dental services. An "assignment of benefits" is the transfer of health care coverage reimbursement benefits or other rights under an insurance policy, subscription contract, or health care plan by an insured, subscriber, or plan enrollee to a health care provider or hospital.

01/28/16 House: Assigned C & L sub: Subcommittee #1
02/03/16 House: Impact statement from SCC (HB1251)
02/04/16 House: Subcommittee recommends continuing to 2017
02/11/16 House: Continued to 2017 in Commerce and Labor
12/01/16 House: Left in Commerce and Labor

HB 1656 Health insurance; proton radiation therapy coverage decisions.

Chief patron: Yancey

Summary as passed:

Health insurance; proton radiation therapy coverage decisions. Prohibits health insurance policies and plans from holding proton radiation therapy to a higher standard of clinical evidence for benefit coverage decisions than is applied for other types of radiation therapy treatment. The measure applies to policies and plans that provide coverage for cancer therapy. The bill contains an emergency clause.

EMERGENCY

02/16/17 Senate: Engrossed by Senate as amended
02/16/17 Senate: Passed Senate with amendment (40-Y 0-N)
02/20/17 House: Placed on Calendar
02/20/17 House: Senate amendment agreed to by House (90-Y 3-N)
02/20/17 House: VOTE: ADOPTION EMERGENCY (90-Y 3-N)

HB 1813 Health insurance; assignment of benefits.

Chief patron: Leftwich

Summary as introduced:
Health insurance; assignment of benefits. Prohibits insurers issuing individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis, corporations providing individual or group accident and sickness subscription contracts, health maintenance organizations providing health care plans for health care services, and dental services plans offering or administering prepaid dental services from refusing to accept assignments of benefits executed by covered individuals in favor of health care providers and hospitals. The measure defines an assignment of benefits as the transfer of health care coverage reimbursement benefits or other rights under an insurance policy, subscription contract, or health care plan by an insured, subscriber, or plan enrollee to a health care provider or hospital.

02/06/17 House: Read second time
02/06/17 House: Amendment by Delegate Leftwich withdrawn
02/06/17 House: Motion to rerefer to committee agreed to
02/06/17 House: Rereferred to Commerce and Labor
02/08/17 House: Left in Commerce and Labor

HB 1985 Health benefit plans; sale by authorized foreign health insurers.

Chief patron: Webert

Summary as introduced:
Health benefit plans; sale by authorized foreign health insurers. Establishes a procedure by which the State Corporation Commission may authorize health insurers licensed to sell health benefit plans in any other state to sell health benefit plans in Virginia without obtaining a license to engage in the business of insurance in Virginia or complying with other requirements applicable to Virginia-licensed insurers. A health benefit plan sold by an authorized foreign health insurer is not be required to include state-mandated health benefits. The measure establishes criteria to be used by the Commission in determining whether to authorize a foreign health insurer to sell, offer, or provide a health benefit plan in the Commonwealth. The measure authorizes the Commission to conduct market conduct and solvency examinations of any foreign health insurer that has applied for, or has received, authorization to sell health benefit plans in Virginia. The measure also specifies disclosures that an authorized foreign health insurer is required to include in applications and policies. The measure has a delayed effective date of January 1, 2018.

01/10/17 House: Prefiled and ordered printed; offered 01/11/17 17103179D
01/10/17 House: Referred to Committee on Commerce and Labor
01/25/17 House: Impact statement from SCC (HB1985)
01/26/17 House: Tabled in Commerce and Labor

HB 1995 Health insurance; coverage for autism spectrum disorder.

Chief patron: Greason

Summary as introduced:

Health insurance; coverage for autism spectrum disorder. Requires health insurers, health care subscription plans, and health maintenance organizations to provide coverage for the diagnosis and treatment of autism spectrum disorder in individuals of any age. Currently, such coverage is required to be provided for individuals from age two through age 10. The provision applies with respect to insurance policies, subscription contracts, and health care plans delivered, issued for delivery, reissued, or extended on or after January 1, 2018.

01/10/17 House: Referred to Committee on Commerce and Labor
01/17/17 House: Assigned C & L sub: Subcommittee #1
01/18/17 House: Impact statement from SCC (HB1995)
01/19/17 House: Subcommittee recommends laying on the table
02/08/17 House: Left in Commerce and Labor

HB 2037 Health insurance; calculation of cost-sharing provisions.

Chief patron: Miller

Summary as passed House:

Health insurance; calculation of cost-sharing provisions. Provides that when there is no amount actually paid or payable by a health insurer, health services plan, or health maintenance organization to a provider for the services provided, the insurer, health services plan, or health maintenance organization shall use such insurer's, health services plan's, or health maintenance organization's pre-established allowed amount to calculate the amount payable by the insured for such services.

02/20/17 Senate: Read third time
02/20/17 Senate: Reading of substitute waived
02/20/17 Senate: Floor substitute printed to LIS only 17105547D-S1 (Wagner)
02/20/17 Senate: Chair rules substitute not germane
02/20/17 Senate: Passed Senate (40-Y 0-N)

HB 2103 Health insurance; benefit exchange.

Chief patron: Byron

Summary as introduced:
Health benefit exchange. Repeals provisions that direct the State Corporation Commission and Virginia Department of Health to perform plan management functions, including rate review, as required for participation in the federal health benefit exchange established pursuant to the federal Patient Protection and Affordable Care Act (the Act). Other provisions that refer to the federal health benefit exchange are also eliminated. The measure shall become effective 60 days after the date that the provisions of the Act that provide for the establishment of a federally operated health benefit exchange are repealed or otherwise become unenforceable.

01/10/17 House: Prefiled and ordered printed; offered 01/11/17 17101913D
01/10/17 House: Referred to Committee on Commerce and Labor
01/30/17 House: Impact statement from SCC (HB2103)
02/02/17 House: Stricken from docket by Commerce and Labor

HB 2107 Health Insurance Reform Commission; assessment sent to Bureau of Insurance.

Chief patron: Byron

Summary as introduced:
Health Insurance Reform Commission; Bureau of Insurance assessment. Provides that the Chairman of the standing committee requesting the Health Insurance Reform Commission (the Commission) to assess a proposed mandated health insurance benefit or provider shall send a copy of such request to the Bureau of Insurance of the State Corporation Commission (the Bureau). The bill requires the Bureau to prepare an analysis of the proposed mandate upon receipt of the copy of the request. Current law requires the Commission to request the Bureau to prepare such assessment. The bill repeals the July 1, 2017, sunset provision for the Health Insurance Reform Commission.

02/16/17 Senate: Passed Senate (40-Y 0-N)
02/20/17 House: Enrolled
02/20/17 House: Bill text as passed House and Senate (HB2107ER)
02/21/17 House: Enrolled Bill communicated to Governor on 2/21/17
02/21/17 Governor: Governor's Action Deadline Midnight, March 27, 2017

HB 2233 Health benefits; sale of plans offered by foreign health insurers.

Chief patron: Cline

Summary as passed House:

Health benefit plans offered by foreign health insurers. Authorizes any foreign health insurer to sell individual or group health benefit plans in the Commonwealth if it is approved to sell such plans in the foreign health insurer's domiciliary state. The measure establishes requirements applicable to such benefit plans, including provisions for registration, disclosure, marketing, and financial condition. The measure has a delayed effective date of July 1, 2018.

02/01/17 House: VOTE: PASSAGE (66-Y 32-N)
02/02/17 House: Impact statement from SCC (HB2233H1)
02/02/17 Senate: Constitutional reading dispensed
02/02/17 Senate: Referred to Committee on Commerce and Labor
02/13/17 Senate: Passed by indefinitely in Commerce and Labor with letter (11-Y 3-N)

HB 2267 Health benefit plans; coverage for hormonal contraceptives.

Chief patron: Filler-Corn

Summary as passed House:

Health benefit plans; coverage for hormonal contraceptives. Requires any health benefit plan that is amended, renewed, or delivered on or after January 1, 2018, that provides coverage for hormonal contraceptives to cover up to a 12-month supply of hormonal contraceptives when dispensed or furnished at one time for a covered person or at a location licensed or otherwise authorized to dispense drugs or supplies. Such a plan is prohibited, in the absence of clinical contraindications, from imposing utilization controls or other forms of medical management limiting the supply of hormonal contraceptives that may be dispensed or furnished by a provider or pharmacy, or at a location licensed or otherwise authorized to dispense drugs or supplies, to an amount that is less than a 12-month supply. The measure does not require a provider to prescribe, furnish, or dispense 12 months of self-administered hormonal contraceptives at one time. The measure also provides that it shall not be construed to exclude coverage for hormonal contraceptives as prescribed by a provider for reasons other than contraceptive purposes, such as decreasing the risk of ovarian cancer or eliminating symptoms of menopause, or for contraception that is necessary to preserve the life or health of an enrollee.

02/16/17 Senate: Passed Senate (34-Y 6-N)
02/20/17 House: Enrolled
02/20/17 House: Bill text as passed House and Senate (HB2267ER)
02/21/17 House: Enrolled Bill communicated to Governor on 2/21/17
02/21/17 Governor: Governor's Action Deadline Midnight, March 27, 2017

HB 2400 Health insurance; use of drug pricing benchmark value.

Chief patron: Head

Summary as introduced:
Drug pricing benchmark value. Requires health insurers and other carriers to utilize the same drug pricing benchmark value to reimburse providers, to charge the sponsor of a health plan, and to develop premiums for a health benefit plan. The measure defines a drug pricing benchmark value as the base price of a prescription drug from which the carrier may deviate for reimbursement purposes.

01/18/17 House: Presented and ordered printed 17102859D
01/18/17 House: Referred to Committee on Commerce and Labor
01/31/17 House: Impact statement from SCC (HB2400)
01/31/17 House: Tabled in Commerce and Labor

HB 2411 Health insurance; reinstating pre-Affordable Care Act provisions.

Chief patron: Byron

Summary as passed:

Health insurance; reinstating pre-Affordable Care Act provisions. Repeals provisions that were added, and restores provisions that were amended or repealed, by the General Assembly since 2011 in efforts to bring the laws of the Commonwealth in conformity with requirements of the federal Patient Protection and Affordable Care Act. The measure will become effective on the later of July 1, 2017, or the effective date of federal legislation repealing the Act.

02/15/17 Senate: Engrossed by Senate as amended
02/15/17 Senate: Passed Senate with amendment (21-Y 19-N)
02/15/17 House: Placed on Calendar
02/15/17 House: Senate amendment agreed to by House (65-Y 32-N)
02/15/17 House: VOTE: ADOPTION (65-Y 32-N)

HJ 707 Governor; 2018-2020 proposed budget; access to array of programs, services,& benefits; Medicaid.

Chief patron: Plum

Summary as introduced:
Governor; 2018-2020 proposed budget; access to full array of programs, services, and benefits available under Medicaid. Encourages the Governor to include in his 2018-2020 proposed budget such language and amounts necessary to ensure access to the full array of programs, services, and benefits available under the federal Medicaid program.

01/11/17 House: Prefiled and ordered printed; offered 01/11/17 17103304D
01/11/17 House: Referred to Committee on Appropriations
01/12/17 House: Assigned App. sub: Health & Human Resources
01/24/17 House: Subcommittee recommends laying on the table
02/08/17 House: Left in Appropriations

HJ 710 Governor; enter into agreements regarding Medicaid services, benefits, and programs.

Chief patron: Plum

Summary as introduced:
Governor; enter into agreements regarding Medicaid services, benefits, and programs. Encourages the Governor to enter into an agreement with the U.S. Secretary of Health and Human Services to extend to all eligible residents of the Commonwealth the full range of services, benefits, and programs available under federal law and regulations through the Medicaid program.

01/11/17 House: Prefiled and ordered printed; offered 01/11/17 17103948D
01/11/17 House: Referred to Committee on Appropriations
01/12/17 House: Assigned App. sub: Health & Human Resources
01/24/17 House: Subcommittee recommends laying on the table
02/08/17 House: Left in Appropriations

SB 383 Health insurance; parity of coverage for oral chemotherapy medications.

Chief patron: Vogel

Summary as introduced:
Health insurance; parity of coverage for oral chemotherapy medications. Requires health insurers, health care subscription plans, and health maintenance organizations, whose policies provide coverage for cancer chemotherapy treatment, to provide coverage for a prescribed, orally administered anticancer medication on a basis no less favorable than that on which it provides coverage for intravenously administered or injected anticancer medications. Such a policy, contract, or plan shall not require a higher copayment, deductible, or coinsurance amount for a prescribed, orally administered anticancer medication than what it requires for an intravenously administered or injected anticancer medication that is provided, regardless of formulation or benefit category determination by the insurer, corporation, or health maintenance organization. The measure applies to the state employees' health insurance plan and to the local choice health program. The measure replaces a provision enacted in 2012 that requires health insurers, health care subscription plans, and health maintenance organizations whose policies, contracts, or plans include coverage for intravenously administered, injected, and orally administered anticancer drugs to consistently apply the criteria for establishing cost sharing applicable to orally administered cancer chemotherapy drugs and cancer chemotherapy drugs that are administered intravenously or by injection.

01/11/16 Senate: Prefiled and ordered printed; offered 01/13/16 16102574D
01/11/16 Senate: Referred to Committee on Commerce and Labor
02/05/16 Senate: Impact statement from SCC (SB383)
02/08/16 Senate: Continued to 2017 in Commerce and Labor (10-Y 0-N)
12/02/16 Senate: Left in Commerce and Labor

SB 442 Health benefit plans; prescription drugs; tiers.

Chief patron: Dance

Summary as introduced:
Health benefit plans; prescription drugs; tiers. Prohibits a health carrier offering a health benefit plan that provides coverage for prescription drugs from implementing a formulary that places a prescription drug on the highest cost-sharing tier unless at least one prescription drug that is in the same therapeutic class and is a medically appropriate alternative treatment for a given disease or condition is available at a lower cost-sharing tier under the formulary.

01/12/16 Senate: Prefiled and ordered printed; offered 01/13/16 16102529D
01/12/16 Senate: Referred to Committee on Commerce and Labor
01/29/16 Senate: Impact statement from SCC (SB442)
02/08/16 Senate: Continued to 2017 in Commerce and Labor (14-Y 0-N)
12/02/16 Senate: Left in Commerce and Labor

SB 696 Medicare; supplement policies for individuals under age 65.

Chief patron: Deeds

Summary as introduced:
Medicare supplement policies for individuals under age 65. Requires insurers issuing Medicare supplement policies in the Commonwealth to offer the opportunity of enrolling in a Medicare supplement policy to any individual who resides in the Commonwealth, is enrolled in Medicare Part B, and is eligible for Medicare by reason of disability.

02/01/16 Senate: Impact statement from SCC (SB696)
02/15/16 Senate: Committee substitute printed to Web only 16105035D-S1
02/15/16 Senate: Continued to 2017 in Commerce and Labor (15-Y 0-N)
02/17/16 Senate: Impact statement from SCC (SB696S1)
12/02/16 Senate: Left in Commerce and Labor

SB 752 Health insurance provider contracts; accepting enrollees as patients.

Chief patron: Surovell

Summary as introduced:
Health insurance provider contracts; accepting enrollees as patients. Requires certain contracts between a health insurance carrier and a provider of health care services to include provisions that prohibit a participating provider from (i) refusing or declining to accept an enrollee who has sustained an injury as a patient or (ii) refusing or declining to provide covered services to an enrollee who has sustained an injury on the basis of the mechanism of the injury sustained by the enrollee. The State Corporation Commission shall not have jurisdiction to adjudicate individual controversies arising out of this measure.

01/22/16 Senate: Presented and ordered printed 16100576D
01/22/16 Senate: Referred to Committee on Commerce and Labor
01/31/16 Senate: Impact statement from SCC (SB752)
02/01/16 Senate: Continued to 2017 in Commerce and Labor (12-Y 0-N)
12/02/16 Senate: Left in Commerce and Labor

SB 1166 Insurance; preauthorization for abuse-deterrent opioids.

Chief patron: Reeves

Summary as introduced:
Insurance; preauthorization for abuse abuse-deterrent opioids. Requires any health carrier offering a health benefit plan that covers prescription drugs and applies a formulary to such coverage to offer in its formulary at least two classes of abuse-deterrent opioids as a tier 1 option that does not require the prescribing provider to utilize a preauthorization process.

01/09/17 Senate: Prefiled and ordered printed; offered 01/11/17 17102495D
01/09/17 Senate: Referred to Committee on Commerce and Labor
01/29/17 Senate: Impact statement from SCC (SB1166)
01/30/17 Senate: Passed by indefinitely in Commerce and Labor with letter (14-Y 1-N)

SB 1301 Health insurance; balance billing.

Chief patron: Vogel

Summary as introduced:
Health insurance; balance billing. Authorizes a health care provider that does not participate in a health insurance carrier's provider network to bill an individual covered under a health benefit plan issued by the carrier for the balance of the provider's fees and charges remaining due after any payment by the carrier or other third party payer only if the covered person and the nonparticipating provider have entered into an express contract under which the covered person has undertaken to pay such balance. The measure establishes requirements for express contracts. If the covered person and nonparticipating provider have not entered into an express contract prior to the provision of the service, the measure provides that the covered person is obligated by an implied contract to pay the reasonable value of the health care services provided by the nonparticipating provider, less any other amounts received. The measure has a delayed effective date of January 1, 2018.

01/10/17 Senate: Prefiled and ordered printed; offered 01/11/17 17103060D
01/10/17 Senate: Referred to Committee on Commerce and Labor
01/23/17 Senate: Stricken at request of Patron in Commerce and Labor (15-Y 0-N)
01/24/17 Senate: Impact statement from SCC (SB1301)

SB 1326 Medicare; supplement policies for individuals under age 65.

Chief patron: Carrico

Summary as introduced:
Medicare supplement policies for individuals under age 65. Requires insurers issuing Medicare supplement policies in the Commonwealth to offer the opportunity of enrolling in a Medicare supplement policy to any individual who resides in the Commonwealth, is enrolled in Medicare Part B, and is eligible for Medicare by reason of disability not to include individuals with end-stage renal disease. The provisions of the measure are applicable to health plans and health maintenance organizations.

01/10/17 Senate: Prefiled and ordered printed; offered 01/11/17 17102781D
01/10/17 Senate: Referred to Committee on Commerce and Labor
01/20/17 Senate: Impact statement from SCC (SB1326)
01/30/17 Senate: Stricken at request of Patron in Commerce and Labor (15-Y 0-N)

SB 1351 Medicare; supplement policies for individuals under age 65.

Chief patron: Deeds

Summary as introduced:
Medicare supplement policies for individuals under age 65. Requires insurers issuing Medicare supplement policies in the Commonwealth to offer the opportunity of enrolling in a Medicare supplement policy to any individual who resides in the Commonwealth, is enrolled in Medicare Part B, and is under age 65 and eligible for Medicare by reason of disability.

01/11/17 Senate: Prefiled and ordered printed; offered 01/11/17 17101815D
01/11/17 Senate: Referred to Committee on Commerce and Labor
01/20/17 Senate: Impact statement from SCC (SB1351)
01/23/17 Senate: Stricken at request of Patron in Commerce and Labor (15-Y 0-N)

SB 1513 Health insurance; assignment of benefits.

Chief patron: Wagner

Summary as introduced:
Health insurance; assignment of benefits. Prohibits insurers issuing individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis, corporations providing individual or group accident and sickness subscription contracts, health maintenance organizations providing health care plans for health care services, and dental services plans offering or administering prepaid dental services from refusing to accept assignments of benefits executed by covered individuals in favor of health care providers and hospitals. The measure defines an assignment of benefits as the transfer of health care coverage reimbursement benefits or other rights under an insurance policy, subscription contract, or health care plan by an insured, subscriber, or plan enrollee to a health care provider or hospital.

01/19/17 Senate: Presented and ordered printed 17104192D
01/19/17 Senate: Referred to Committee on Commerce and Labor
01/25/17 Senate: Impact statement from SCC (SB1513)
02/03/17 Senate: Passed by indefinitely in Commerce and Labor with letter (15-Y 0-N)

SB 1590 Health insurance; coverage for autism spectrum disorder.

Chief patron: Wagner

Summary as passed Senate:

Health insurance; coverage for autism spectrum disorder. Requires health insurers, health care subscription plans, and health maintenance organizations to provide coverage for the diagnosis and treatment of autism spectrum disorder in individuals from age two through age 12. Currently, such coverage is required to be provided for individuals from age two through age 10. The provision applies with respect to insurance policies, subscription contracts, and health care plans delivered, issued for delivery, reissued, or extended on or after January 1, 2018.

02/09/17 House: Placed on Calendar
02/09/17 House: Read first time
02/09/17 House: Referred to Committee on Commerce and Labor
02/16/17 Senate: Impact statement from SCC (SB1590E)
02/21/17 House: Left in Commerce and Labor

Counts: HB: 14 HJ: 2 SB: 10