Legislation: batch E — CA TN VA VT WA WI WV WY

Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>

legislation/us/states/va/2026/hb-481.md

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+---
+type: "Bill"
+title: "Prior authorization; requiring physician review for denial."
+description: "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."
+jurisdiction: "us/states/va"
+legislature: "Virginia General Assembly"
+session: "2026"
+identifier: "HB 481"
+citation: "Virginia HB 481 (2026)"
+classification: ["bill"]
+subjects: []
+status: "enacted"
+primary_sponsors: ["Patrick A. Hope"]
+version_count: 5
+action_count: 36
+vote_count: 7
+first_action: "2026-01-12"
+last_action: "2026-04-13"
+source: "openstates"
+source_identifier: "ocd-bill/7eb4da70-810f-42a9-a17c-1a2f5492d52e"
+source_url: "https://lis.virginia.gov/bill-details/20261/HB481"
+source_hash: "1900133c5119c480a02985223a414087f55af1f9bddb7ca13914bfe53299346f"
+vintage: "2026-07-01"
+source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
+retrieved_at: "2026-07-06"
+confidence: "reported"
+tags: ["legislation", "bill", "us-va"]
+---
+
+# Virginia HB 481 (2026) — Prior authorization; requiring physician review for denial.
+
+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.
+
+## Version chain
+
+The bill's text revisions, in order — the diff chain from filing to enrollment.
+
+1. **Introduced** (filed) — [source](https://lis.blob.core.windows.net/files/1084610.PDF)
+2. **Commerce and Labor Substitute** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1190071.PDF)
+3. **Labor and Commerce Substitute** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1103521.PDF)
+4. **Subcommittee #1 Subcommittee Substitute** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1098966.PDF)
+5. **Enrolled** (enrolled) — [source](https://lis.blob.core.windows.net/files/1210689.PDF)
+
+## Votes
+
+- H VOTE: — **98–1** (pass) · lower
+- Reported from Commerce and Labor with substitute — **13–0** (pass) · upper
+- Reported from Labor and Commerce with substitute — **22–0** (pass) · lower
+- Subcommittee recommends reporting with substitute — **9–0** (pass) · lower
+- Passage R — **39–0** (pass) · upper
+- Constitutional reading dispensed (on 2nd reading) — **39–0** (pass) · upper
+- H VOTE: — **97–0** (pass) · lower
+
+## Sponsors
+
+- Patrick A. Hope — primary (person)
+- Elizabeth B. Bennett-Parker — cosponsor (person)
+- Kathy K.L. Tran — cosponsor (person)
+- Marcia S. "Cia" Price — cosponsor (person)
+- Rae Cousins — cosponsor (person)
+
+## Timeline
+
+The legislative action history — every referral, reading, and vote.
+
+- **2026-01-12** Prefiled and ordered printed; Offered 01-14-2026 26105194D `filing, introduction`
+- **2026-01-12** Referred to Committee on Labor and Commerce `referral-committee`
+- **2026-01-19** Assigned HCL sub: Subcommittee #1 `referral-committee`
+- **2026-01-27** House subcommittee offered
+- **2026-01-27** Subcommittee recommends reporting with substitute (9-Y 0-N) `substitution`
+- **2026-01-29** Reported from Labor and Commerce with substitute (22-Y 0-N) `committee-passage`
+- **2026-01-29** Committee substitute printed 26106401D-H1 `substitution`
+- **2026-02-02** Read first time `reading-1`
+- **2026-02-03** Moved from Uncontested Calendar to Regular Calendar
+- **2026-02-03** Read second time `reading-2`
+- **2026-02-03** committee substitute agreed to `substitution`
+- **2026-02-03** Engrossed by House - committee substitute `substitution`
+- **2026-02-04** Read third time and passed House (97-Y 0-N 0-A) `passage, reading-3`
+- **2026-02-05** Constitutional reading dispensed (on 1st reading)
+- **2026-02-05** Referred to Committee on Commerce and Labor `referral-committee`
+- **2026-03-02** Senate committee offered
+- **2026-03-02** Reported from Commerce and Labor with substitute (13-Y 0-N) `committee-passage`
+- **2026-03-03** Committee substitute printed 26108765D-S1 `substitution`
+- **2026-03-04** Rules suspended
+- **2026-03-04** Constitutional reading dispensed (on 2nd reading) (39-Y 0-N 0-A)
+- **2026-03-04** Passed by for the day (Voice Vote)
+- **2026-03-05** Read third time `reading-3`
+- **2026-03-05** Commerce and Labor Substitute agreed to
+- **2026-03-05** Engrossed by Senate - committee substitute `substitution`
+- **2026-03-05** Passed Senate with substitute Block Vote (39-Y 0-N 0-A) `passage`
+- **2026-03-05** Fiscal Impact Statement from State Corporation Commission (HB481)
+- **2026-03-09** Passed by for the day
+- **2026-03-10** Senate substitute agreed to by House (98-Y 1-N 0-A) `substitution`
+- **2026-03-30** Enrolled `enrolled`
+- **2026-03-30** Bill text as passed House and Senate (HB481ER) `passage`
+- **2026-03-30** Signed by President `passage`
+- **2026-03-31** Signed by Speaker `passage`
+- **2026-03-31** Enrolled Bill communicated to Governor on March 31, 2026 `enrolled, executive-receipt`
+- **2026-03-31** Governor's Action Deadline 11:59 p.m., April 13, 2026 `executive-receipt`
+- **2026-04-13** Fiscal Impact Statement from State Corporation Commission (HB481)
+- **2026-04-13** Approved by Governor-Chapter 925 (effective 7/1/2026) `executive-signature`
+
+## Source
+
+OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/7eb4da70-810f-42a9-a17c-1a2f5492d52e`. Confidence: reported (aggregated from official Virginia legislature records).
+