VA SB731 | 2019 | Regular Session

Status

Spectrum: Partisan Bill (Republican 1-0)
Status: Introduced on January 10 2018 - 25% progression, died in committee
Action: 2018-11-30 - Left in Commerce and Labor
Pending: Senate Commerce and Labor Committee
Text: Latest bill text (Prefiled) [HTML]

Summary

Health insurance plans; prior authorization for drug Health insurance plans; prior authorization for drug benefits or surgical procedures. Provides that prior authorization requirements currently applicable to drug benefits are applicable to the process for a carrier's approval of surgical procedures. The measure requires contracts between an insurance carrier and a participating health care provider that require the carrier's prior authorization to include provisions that prohibit the carrier, after it has approved a prior authorization request submitted by a participating health care provider, from (i) withdrawing or retracting its approval of the request or (ii) declining or refusing to pay a claim submitted for the drug benefit or surgical procedure. The measure provides that if a health plan or provider contract states that prior authorization is not required for a specific drug benefit or surgical procedure, the carrier shall not refuse to pay a claim submitted for the drug benefit or surgical procedure. The measure addresses the standards applicable to electronic submissions of requests for prior authorization and specifies that requests may be submitted in paper if the provider meets certain criteria. Finally, the measure exempts a drug benefit from prior authorization requirements if prior authorization has been approved for the drug benefit in 90 percent or more of the requests for prior authorization submitted by the provider in the preceding 12 months or if the drug is a generic medication. These provisions apply to provider contracts

Tracking Information

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Title

Health insurance plans; prior authorization for drug benefits or surgical procedures.

Sponsors


Roll Calls

2018-01-29 - Senate - Senate: Continued to 2019 in Commerce and Labor (15-Y 0-N) (Y: 15 N: 0 NV: 0 Abs: 0) [PASS]

History

DateChamberAction
2018-11-30SenateLeft in Commerce and Labor
2018-01-29SenateContinued to 2019 in Commerce and Labor (15-Y 0-N)
2018-01-10SenateReferred to Committee on Commerce and Labor
2018-01-10SenatePrefiled and ordered printed; offered 01/10/18 18104573D

Code Citations

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

Virginia State Sources


Bill Comments

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