---
type: "Bill"
title: "Health insurance; ethics and fairness in carrier business practices, downcoded claims."
description: "Health insurance; ethics and fairness in carrier business practices; downcoded claims. Prohibits a carrier, intermediary, administrator, or representative of a carrier from downcoding a claim unless the decision to downcode is determined by a person or electronic system that reflects correct coding standards and considers all relevant patient data from the billing provider in making the determination. The bill requires a carrier, intermediary, administrator, or representative that downcodes a claim to provide certain notice to the provider. The bill requires that all downcoding dispute decisions are reviewed and adjudicated by a natural person."
jurisdiction: "us/states/va"
legislature: "Virginia General Assembly"
session: "2026"
identifier: "SB 164"
citation: "Virginia SB 164 (2026)"
classification: ["bill"]
subjects: []
status: "enacted"
primary_sponsors: ["Jeremy S. McPike"]
version_count: 7
action_count: 44
vote_count: 7
first_action: "2026-01-07"
last_action: "2026-04-13"
source: "openstates"
source_identifier: "ocd-bill/43461926-7d19-4b55-b40a-9d459f9a0f8f"
source_url: "https://lis.virginia.gov/bill-details/20261/SB164"
source_hash: "ba5acaa47553cb5b3fd2a7c587acd033b9223f2c9e822412bcd5a7df90fd585f"
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 SB 164 (2026) — Health insurance; ethics and fairness in carrier business practices, downcoded claims.

Health insurance; ethics and fairness in carrier business practices; downcoded claims. Prohibits a carrier, intermediary, administrator, or representative of a carrier from downcoding a claim unless the decision to downcode is determined by a person or electronic system that reflects correct coding standards and considers all relevant patient data from the billing provider in making the determination. The bill requires a carrier, intermediary, administrator, or representative that downcodes a claim to provide certain notice to the provider. The bill requires that all downcoding dispute decisions are reviewed and adjudicated by a natural person.

## 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/1083620.PDF)
2. **Commerce and Labor Substitute** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1097327.PDF)
3. **Delegate Shin Amendments** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1193528.HTML)
4. **House Amendments** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1194141.HTML)
5. **Labor and Commerce Substitute** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1185521.PDF)
6. **Subcommittee #1 Subcommittee Substitute** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1179341.PDF)
7. **Enrolled** (enrolled) — [source](https://lis.blob.core.windows.net/files/1202608.PDF)

## Votes

- Constitutional reading dispensed R — **40–0** (pass) · upper
- H VOTE: — **97–1** (pass) · lower
- Concur House Amendments R — **40–0** (pass) · upper
- Reported from Labor and Commerce with substitute — **21–0** (pass) · lower
- Subcommittee recommends reporting with substitute — **9–0** (pass) · lower
- Reported from Commerce and Labor with substitute — **15–0** (pass) · upper
- Passage R — **38–0** (pass) · upper

## Sponsors

- Jeremy S. McPike — primary (person)
- Bill DeSteph — cosponsor (person)

## Timeline

The legislative action history — every referral, reading, and vote.

- **2026-01-07** Prefiled and ordered printed; Offered 01-14-2026 26103299D `filing, introduction`
- **2026-01-07** Referred to Committee on Commerce and Labor `referral-committee`
- **2026-01-26** Senate committee offered
- **2026-01-26** Senate committee offered
- **2026-01-26** Reported from Commerce and Labor with substitute (15-Y 0-N) `committee-passage`
- **2026-01-27** Committee substitute printed 26106195D-S1 `substitution`
- **2026-01-28** Rules suspended
- **2026-01-28** Constitutional reading dispensed Block Vote (on 1st reading) (40-Y 0-N 0-A)
- **2026-01-28** Passed by for the day Block Vote (Voice Vote)
- **2026-01-28** Passed by for the day
- **2026-01-29** Read second time `reading-2`
- **2026-01-29** Commerce and Labor Substitute agreed to
- **2026-01-29** Engrossed by Senate (Voice Vote)
- **2026-01-29** Engrossed by Senate - committee substitute `substitution`
- **2026-01-30** Read third time and passed Senate `passage, reading-3`
- **2026-02-04** Placed on Calendar
- **2026-02-04** Read first time `reading-1`
- **2026-02-04** Referred to Committee on Labor and Commerce `referral-committee`
- **2026-02-19** Assigned HCL sub: Subcommittee #1 `referral-committee`
- **2026-02-24** Subcommittee recommends reporting with substitute (9-Y 0-N) `substitution`
- **2026-02-26** Reported from Labor and Commerce with substitute (21-Y 0-N) `committee-passage`
- **2026-02-27** Committee substitute printed 26108190D-H1 `substitution`
- **2026-03-02** Read second time `reading-2`
- **2026-03-03** Moved from Uncontested Calendar to Regular Calendar
- **2026-03-03** Passed by for the day
- **2026-03-03** Fiscal Impact Statement from State Corporation Commission (SB164)
- **2026-03-04** Read third time `reading-3`
- **2026-03-04** committee substitute rejected
- **2026-03-04** Passed by temporarily
- **2026-03-04** Floor offered Delegate Shin Amendments
- **2026-03-04** Reconsideration of
- **2026-03-04** Labor and Commerce Substituteagreed to by House
- **2026-03-04** Delegate Shin Floor amendments agreed to `amendment-passage`
- **2026-03-04** Engrossed by House - committee substitute as amended `substitution`
- **2026-03-04** Passed House with substitute with amendments (97-Y 1-N 0-A) `passage`
- **2026-03-06** House substitute with amendments agreed to by Senate (40-Y 0-N 0-A) `amendment-passage, substitution`
- **2026-03-12** Enrolled `enrolled`
- **2026-03-12** Bill text as passed Senate and House (SB164ER) `passage`
- **2026-03-12** Signed by Speaker `passage`
- **2026-03-12** Signed by President `passage`
- **2026-03-14** Enrolled Bill communicated to Governor on March 14, 2026 `enrolled, executive-receipt`
- **2026-03-14** Governor's Action Deadline 11:59 p.m., April 13, 2026 `executive-receipt`
- **2026-03-24** Fiscal Impact Statement from State Corporation Commission (SB164)
- **2026-04-13** Approved by Governor-Chapter 881 (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/43461926-7d19-4b55-b40a-9d459f9a0f8f`. Confidence: reported (aggregated from official Virginia legislature records).