SEARCH SITE
VIRGINIA LAW PORTAL
- Code of Virginia
- Virginia Administrative Code
- Constitution of Virginia
- Charters
- Authorities
- Compacts
- Uncodified Acts
- RIS Users (account required)
SEARCHABLE DATABASES
- Bills & Resolutions
session legislation - Bill Summaries
session summaries - Reports to the General Assembly
House and Senate documents - Legislative Liaisons
State agency contacts
ACROSS SESSIONS
- Subject Index: Since 1995
- Bills & Resolutions: Since 1994
- Summaries: Since 1994
Developed and maintained by the Division of Legislative Automated Systems.
2019 SESSION
SB 1607 Health insurance; carrier business practices, authorization of health care services.
Introduced by: Siobhan S. Dunnavant | all patrons ... notes | add to my profiles
SUMMARY AS PASSED SENATE: (all summaries)
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.
FULL TEXT
- 01/09/19 Senate: Prefiled and ordered printed; offered 01/09/19 19103921D pdf | impact statement
- 01/31/19 Senate: Committee substitute printed 19105371D-S1 pdf | impact statement
- 02/22/19 Senate: Bill text as passed Senate and House (SB1607ER) pdf | impact statement
- 03/21/19 Governor: Acts of Assembly Chapter text (CHAP0683) pdf
HISTORY
- 01/09/19 Senate: Prefiled and ordered printed; offered 01/09/19 19103921D
- 01/09/19 Senate: Referred to Committee on Commerce and Labor
- 01/31/19 Senate: Reported from Commerce and Labor with substitute (15-Y 0-N)
- 01/31/19 Senate: Committee substitute printed 19105371D-S1
- 02/01/19 Senate: Constitutional reading dispensed (40-Y 0-N)
- 02/04/19 Senate: Read second time
- 02/04/19 Senate: Reading of substitute waived
- 02/04/19 Senate: Committee substitute agreed to 19105371D-S1
- 02/04/19 Senate: Engrossed by Senate - committee substitute SB1607S1
- 02/04/19 Senate: Constitutional reading dispensed (40-Y 0-N)
- 02/04/19 Senate: Passed Senate (40-Y 0-N)
- 02/06/19 House: Placed on Calendar
- 02/06/19 House: Read first time
- 02/06/19 House: Referred to Committee on Commerce and Labor
- 02/14/19 House: Reported from Commerce and Labor (22-Y 0-N)
- 02/18/19 House: Read second time
- 02/19/19 House: Read third time
- 02/19/19 House: Passed House BLOCK VOTE (98-Y 0-N)
- 02/19/19 House: VOTE: BLOCK VOTE PASSAGE (98-Y 0-N)
- 02/19/19 House: Reconsideration of House passage agreed to by House
- 02/19/19 House: Passed House BLOCK VOTE (99-Y 0-N)
- 02/19/19 House: VOTE: BLOCK VOTE PASSAGE #2 (99-Y 0-N)
- 02/22/19 Senate: Enrolled
- 02/22/19 Senate: Bill text as passed Senate and House (SB1607ER)
- 02/22/19 Senate: Signed by President
- 02/22/19 House: Signed by Speaker
- 03/04/19 Senate: Enrolled Bill Communicated to Governor on March 4, 2019
- 03/04/19 Governor: Governor's Action Deadline Midnight, March 26, 2019
- 03/21/19 Governor: Approved by Governor-Chapter 683 (effective 7/1/19)
- 03/21/19 Governor: Acts of Assembly Chapter text (CHAP0683)