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1995 SESSION

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LD7645661
SENATE BILL NO. 958 Offered January 23, 1995 A BILL to amend the Code of Virginia by adding in Chapter 3 of Title 38.2 a section numbered 38.2-323, relating to insurance; determination of medical necessity. ---------- Patrons--Gartlan and Holland, C.A. ---------- Referred to the Committee on Commerce and Labor ----------

Be it enacted by the General Assembly of Virginia:

1. That the Code of Virginia is amended by adding in Chapter 3 of Title 38.2 a section numbered 38.2-323 as follows:

§ 38.2-323. Determination of medical necessity; prohibited policy provisions.

It shall be illegal and contrary to the public policy of this Commonwealth for any insurance policy or any contract regarding, relating to, or providing health care services, limited health care services, or ancillary service benefits, as defined in this title, to contain any provision providing that a determination of medical necessity, appropriateness or efficiency as it relates to hospital, medical or other health care resources shall be determined within the sole discretion of the insurer, health maintenance organization, hospital service corporation, health service plan or preferred provider organization or any other organization authorized to offer health benefits in this Commonwealth.