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52Nov 3 election

Prior authorization; requiring physician review for denial.

It became law on Apr 13.

VA HB 481 · House Bill · 2026

Stage
Became law
Started in
House
Sponsors
Latest action
Apr 13

Where it stands

  1. Introduced (Done)

  2. Committee (Done)

  3. Floor (Done)

  4. Law (Done)

    Apr 13

What it does

Prior authorization; requiring physician review for denial. Prohibits a health insurance carrier from making an adverse determination of a prior authorization request (i) for prescription drugs unless such denial has been reviewed and approved by a licensed physician or, if a licensed physician is not available, by a licensed pharmacist or (ii) for health care services unless such adverse determination has been reviewed and approved by (a) a licensed physician; (b) in the case of mental health services, a licensed mental health provider if a licensed physician is unavailable; or (c) in the case of dental services, a licensed dentist if a licensed physician is unavailable.

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Where it goes next

Law in Virginia. Agencies now write the rules that carry it out, and courts can stay or strike it.

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Who is involved

VA HB 481
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Sponsors

The lawmakers who put their names on it, lead sponsors first.

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