---
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).