Bill Text: VA HB1174 | 2022 | Regular Session | Introduced


Bill Title: Health carriers; denial of coverage, quarterly report, sunset provisions.

Spectrum: Partisan Bill (Democrat 12-0)

Status: (Introduced - Dead) 2022-02-15 - Left in Commerce and Energy [HB1174 Detail]

Download: Virginia-2022-HB1174-Introduced.html
22103705D
HOUSE BILL NO. 1174
Offered January 17, 2022
A BILL to require each health carrier in the Commonwealth to submit a quarterly report of all first-time denials of coverage.
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Patron-- Adams, D.M.
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Committee Referral Pending
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Be it enacted by the General Assembly of Virginia:

1. §1. Each health carrier in the Commonwealth shall submit to the State Corporation Commission on a quarterly basis a report of all first-time denials of coverage, including any denials of coverage on the basis of a preexisting condition exclusion, as defined in §38.2-3438 of the Code of Virginia, and any denials of coverage based on a determination that the health care service or treatment recommended or requested is experimental or investigational, as described in §38.2-3563 of the Code of Virginia. A denial of coverage may entitle a covered person to file a request for an internal appeal or an external review, pursuant to the provisions of Chapter 35.1 (§38.2-3556 et seq.) of Title 38.2 of the Code of Virginia. Upon any denial of coverage, adverse determination, or final adverse determination, a health carrier shall issue a statement to the covered person informing him of the right to an internal appeal or, if applicable, an external review, as required by §38.2-3570 of the Code of Virginia. The provisions of this act shall expire on July 1, 2024.

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