---
type: "Bill"
title: "Accident and sickness insurance; step therapy protocols."
description: "Requires carriers issuing health benefit plans that develop step therapy protocols for a health benefit plan to ensure that those step therapy protocols are (i) developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members; (ii) based on peer-reviewed research and medical practice; and (iii) continually updated based on a review of new evidence, research, and newly developed treatments. The measure requires that when coverage of a prescription drug for the treatment of a medical condition is restricted for use by a carrier or utilization review organization through the use of a step therapy protocol, the patient and prescribing provider have access to a clear, readily accessible, and convenient process to request a step therapy exception. The measure establishes conditions under which a request for a step therapy exception shall be granted and authorizes a patient to appeal a step therapy exception request denial. The provisions of the measure shall apply to any health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2020."
jurisdiction: "us/states/va"
legislature: "Virginia General Assembly"
session: "2019"
identifier: "HB 2126"
citation: "Virginia HB 2126 (2019)"
classification: ["bill"]
subjects: ["Insurance"]
status: "enacted"
primary_sponsors: ["Glenn R. Davis"]
version_count: 6
action_count: 27
vote_count: 9
first_action: "2019-01-08"
last_action: "2019-03-12"
source: "openstates"
source_identifier: "ocd-bill/9ccc0681-bfb7-4118-b748-21dae22311c1"
source_url: "http://lis.virginia.gov/cgi-bin/legp604.exe?191+sum+HB2126"
source_hash: "8f3a0cfd773e5240ab2c2d0c1dfa1a2a7dce7559e23c76b516131450a4c5a232"
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 2126 (2019) — Accident and sickness insurance; step therapy protocols.

Requires carriers issuing health benefit plans that develop step therapy protocols for a health benefit plan to ensure that those step therapy protocols are (i) developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members; (ii) based on peer-reviewed research and medical practice; and (iii) continually updated based on a review of new evidence, research, and newly developed treatments. The measure requires that when coverage of a prescription drug for the treatment of a medical condition is restricted for use by a carrier or utilization review organization through the use of a step therapy protocol, the patient and prescribing provider have access to a clear, readily accessible, and convenient process to request a step therapy exception. The measure establishes conditions under which a request for a step therapy exception shall be granted and authorizes a patient to appeal a step therapy exception request denial. The provisions of the measure shall apply to any health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2020.

## Version chain

The bill's text revisions, in order — the diff chain from filing to enrollment.

1. **Governor: Acts of Assembly Chapter text (CHAP0337)** (committee substitute) — [source](http://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+CHAP0337)
2. **House subcommittee amendments and substitutes adopted** (committee substitute) — [source](https://committees.lis.virginia.gov/subcommitteeaction.aspx?ses=191&bil=HB2126)
3. **House: Bill text as passed House and Senate (HB2126ER)** (committee substitute) — [source](http://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+HB2126ER)
4. **House: Committee substitute printed 19106082D-H1** (committee substitute) — [source](http://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+HB2126H1)
5. **House: Prefiled and ordered printed; offered 01/09/19 19102027D** (committee substitute) — [source](http://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+HB2126)
6. **Senate amendments engrossed** (committee substitute) — [source](http://lis.virginia.gov/cgi-bin/legp604.exe?191+amd+HB2126ASE)

## Votes

- Read third time and passed House — **99–0** (pass) · lower
- Constitutional reading dispensed — **40–0** (pass) · upper
- Passed Senate with amendments — **40–0** (pass) · upper
- Subcommittee recommends reporting with substitute — **6–2** (pass) · lower
- Reported from Commerce and Labor with substitute — **18–1** (pass) · lower
- Reported from Commerce and Labor with amendments — **14–0** (pass) · upper
- Reported from Finance with amendment — **15–0** (pass) · upper
- Finance Committee amendment reconsidered — **40–0** (pass) · upper
- Senate amendments agreed to by House — **99–0** (pass) · lower

## Sponsors

- Glenn R. Davis — primary (person)
- Christopher K. Peace — cosponsor (person)
- Christopher P. Stolle — cosponsor (person)
- Hyland F. "Buddy" Fowler, Jr. — cosponsor (person)
- Jeion A. Ward — cosponsor (person)
- Patrick A. Hope — cosponsor (person)
- Scott A. Surovell — cosponsor (person)

## Timeline

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

- **2019-01-08** Prefiled and ordered printed; offered 01/09/19 19102027D `introduction`
- **2019-01-08** Referred to Committee on Commerce and Labor `referral-committee`
- **2019-01-15** Assigned C & L sub: Subcommittee #1 `referral-committee`
- **2019-02-03** Read first time `reading-1`
- **2019-02-04** Read second time `reading-2`
- **2019-02-04** Committee substitute agreed to 19106082D-H1
- **2019-02-04** Engrossed by House - committee substitute HB2126H1
- **2019-02-05** Read third time and passed House (99-Y 0-N) `passage, reading-3`
- **2019-02-06** Constitutional reading dispensed
- **2019-02-06** Referred to Committee on Commerce and Labor `referral-committee`
- **2019-02-18** Rereferred to Finance `referral-committee`
- **2019-02-20** Read third time `reading-3`
- **2019-02-20** Reading of amendments waived
- **2019-02-20** Committee amendments agreed to
- **2019-02-20** Reading of amendment waived
- **2019-02-20** Committee amendment agreed to
- **2019-02-20** Passed by for the day
- **2019-02-21** Read third time `reading-3`
- **2019-02-21** Committee amendment rejected
- **2019-02-21** Engrossed by Senate as amended
- **2019-02-21** Senate amendments agreed to by House (99-Y 0-N)
- **2019-02-23** Enrolled
- **2019-02-23** Signed by Speaker
- **2019-02-23** Signed by President
- **2019-03-04** Enrolled Bill communicated to Governor on March 4, 2019
- **2019-03-04** Governor's Action Deadline Midnight, March 26, 2019
- **2019-03-12** Approved by Governor-Chapter 337 (effective 1/1/20) `executive-signature`

## Source

OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/9ccc0681-bfb7-4118-b748-21dae22311c1`. Confidence: reported (aggregated from official Virginia legislature records).