VA SB1607 | 2019 | Regular Session

Status

Completed Legislative Action
Spectrum: Partisan Bill (Republican 1-0)
Status: Passed on March 21 2019 - 100% progression
Action: 2019-03-21 - Governor: Acts of Assembly Chapter text (CHAP0683)
Text: Latest bill text (Chaptered) [HTML]

Summary

Health insurance; carrier business practices; authorization of health care services. Provides that if a carrier has previously authorized an invasive or surgical health care service as medically necessary and during the procedure the health care provider discovers clinical evidence prompting the provider to perform a less or more extensive or complicated procedure than was previously authorized, then the carrier shall pay the claim, provided that it is appropriately coded consistent with the procedure actually performed, the additional procedures were not investigative in nature, and the additional procedure was compliant with a carrier's post-service claims process. The measure requires any provider contract between a carrier and a participating health care provider to contain certain specific provisions addressing how carriers interact with prior authorization requests. The measure requires that no prior authorization is required for at least one drug prescribed for substance abuse medication-assisted treatment, provided that (i) the drug is a covered benefit, (ii) the prescription does not exceed the FDA labeled dosages, and (iii) the drug is prescribed consistent with the regulations of the Board of Medicine. The measure clarifies that the 24-hour period during which a carrier is required to communicate to a prescriber if an urgent prior authorization request submitted telephonically or in an alternate method directed by the carrier has been approved, denied, or requires supplementation includes weekend hours. The measure provides that a carrier shall not be required to pay a claim if the carrier has previously authorized health care service and if, during the post-service claims process, it is determined that the claim was submitted fraudulently.

Tracking Information

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Title

Health insurance; carrier business practices, authorization of health care services.

Sponsors


Roll Calls

2019-02-19 - House - House: VOTE: BLOCK VOTE PASSAGE #2 (99-Y 0-N) (Y: 99 N: 0 NV: 0 Abs: 0) [PASS]
2019-02-19 - House - House: VOTE: BLOCK VOTE PASSAGE (98-Y 0-N) (Y: 98 N: 0 NV: 1 Abs: 0) [PASS]
2019-02-14 - House - House: Reported from Commerce and Labor (22-Y 0-N) (Y: 22 N: 0 NV: 0 Abs: 0) [PASS]
2019-02-04 - Senate - Senate: Passed Senate (40-Y 0-N) (Y: 40 N: 0 NV: 0 Abs: 0) [PASS]
2019-02-04 - Senate - Senate: Constitutional reading dispensed (40-Y 0-N) (Y: 40 N: 0 NV: 0 Abs: 0) [PASS]
2019-02-01 - Senate - Senate: Constitutional reading dispensed (40-Y 0-N) (Y: 40 N: 0 NV: 0 Abs: 0) [PASS]
2019-01-31 - Senate - Senate: Reported from Commerce and Labor with substitute (15-Y 0-N) (Y: 15 N: 0 NV: 0 Abs: 0) [PASS]

History

DateChamberAction
2019-03-21 Governor: Acts of Assembly Chapter text (CHAP0683)
2019-03-21 Governor: Approved by Governor-Chapter 683 (effective 7/1/19)
2019-03-04 Governor: Governor's Action Deadline Midnight, March 26, 2019
2019-03-04SenateEnrolled Bill Communicated to Governor on March 4, 2019
2019-02-22HouseSigned by Speaker
2019-02-22SenateSigned by President
2019-02-22SenateBill text as passed Senate and House (SB1607ER)
2019-02-22SenateEnrolled
2019-02-19HouseVOTE: BLOCK VOTE PASSAGE #2 (99-Y 0-N)
2019-02-19HousePassed House BLOCK VOTE (99-Y 0-N)
2019-02-19HouseReconsideration of House passage agreed to by House
2019-02-19HouseVOTE: BLOCK VOTE PASSAGE (98-Y 0-N)
2019-02-19HousePassed House BLOCK VOTE (98-Y 0-N)
2019-02-19HouseRead third time
2019-02-18HouseRead second time
2019-02-14HouseReported from Commerce and Labor (22-Y 0-N)
2019-02-06HouseReferred to Committee on Commerce and Labor
2019-02-06HouseRead first time
2019-02-06HousePlaced on Calendar
2019-02-04SenatePassed Senate (40-Y 0-N)
2019-02-04SenateConstitutional reading dispensed (40-Y 0-N)
2019-02-04SenateEngrossed by Senate - committee substitute SB1607S1
2019-02-04SenateCommittee substitute agreed to 19105371D-S1
2019-02-04SenateReading of substitute waived
2019-02-04SenateRead second time
2019-02-01SenateConstitutional reading dispensed (40-Y 0-N)
2019-01-31SenateCommittee substitute printed 19105371D-S1
2019-01-31SenateReported from Commerce and Labor with substitute (15-Y 0-N)
2019-01-09SenateReferred to Committee on Commerce and Labor
2019-01-09SenatePrefiled and ordered printed; offered 01/09/19 19103921D

Code Citations

ChapterArticleSectionCitation TypeStatute Text
3823407.15(n/a)See Bill Text
3823407.15:2(n/a)See Bill Text

Virginia State Sources

TypeSource
Summaryhttps://lis.virginia.gov/cgi-bin/legp604.exe?191+sum+SB1607
Texthttps://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+SB1607+hil
Texthttps://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+SB1607S1+hil
Texthttps://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+SB1607ER+hil
Texthttps://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+CHAP0683+hil
Roll Callhttps://lis.virginia.gov/cgi-bin/legp604.exe?191+vot+S02V0094+SB1607
Roll Callhttps://lis.virginia.gov/cgi-bin/legp604.exe?191+vot+SV0313SB1607+SB1607
Roll Callhttps://lis.virginia.gov/cgi-bin/legp604.exe?191+vot+SV0347SB1607+SB1607
Roll Callhttps://lis.virginia.gov/cgi-bin/legp604.exe?191+vot+SV0348SB1607+SB1607
Roll Callhttps://lis.virginia.gov/cgi-bin/legp604.exe?191+vot+H14V0186+SB1607
Roll Callhttps://lis.virginia.gov/cgi-bin/legp604.exe?191+vot+HV2959+SB1607
Roll Callhttps://lis.virginia.gov/cgi-bin/legp604.exe?191+vot+HV3002+SB1607

Bill Comments

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