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Fabio 5a13be122b Legislation: batch E — CA TN VA VT WA WI WV WY

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

2026-07-06 17:28:36 -04:00

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type, title, description, jurisdiction, legislature, session, identifier, citation, classification, subjects, status, primary_sponsors, version_count, action_count, vote_count, first_action, last_action, source, source_identifier, source_url, source_hash, vintage, source_snapshot, retrieved_at, confidence, tags

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Bill

Health insurance; definitions, payment to out-of-network providers, emergency services.

Health insurance; payment to out-of-network providers. Provides that when an enrollee receives emergency services from an out-of-network health care provider or receives out-of-network surgical or ancillary services at an in-network facility, the enrollee is not required to pay the out-of-network provider any amount other than the applicable cost-sharing requirement and such cost-sharing requirement cannot exceed the cost-sharing requirement that would apply if the services were provided in-network. The measure also provides that the health carrier's required payment to the out-of-network provider of the services is a commercially reasonable amount based on payments for the same or similar services provided in a similar geographic area. If such provider disputes the amount to be paid by the health carrier, the measure requires the provider and the health carrier to make a good faith effort to reach a resolution on the amount of the reimbursement. If the health carrier and the provider do not agree to a commercially reasonable payment and either party wants to take further action to resolve the dispute, then the measure requires the dispute will be resolved by arbitration. The measure establishes a framework for arbitration of such disputes that includes (i) a timeline for the proceedings, (ii) a method for choosing an arbitrator, (iii) required and optional factors for the arbitrator to consider, (iv) non-disclosure agreements, (v) reporting requirements, and (vi) an appeals process for appeals on certain procedural grounds. The measure requires the State Corporation Commission to contract with Virginia Health Information (VHI) to establish a data set and business protocols to provide health carriers, providers, and arbitrators with data to assist in determining commercially reasonable payments and resolving disputes. The measure requires the Commission, in consultation with health carriers, providers, and consumers, to develop standard language for a notice of consumer rights regarding balance billing. The measure authorizes the Commission, the Board of Medicine, and the Commissioner of Health to levy fines and take action against a health carrier, health care practitioner, or medical care facility, respectively, for a pattern of violations of the prohibition against balance billing. Additionally, the measure prohibits a carrier or provider from initiating arbitration with such frequency as to indicate a general business practice. The measure provides that such provisions do not apply to an entity that provides or administers self-insured or self-funded plans; however, such entities may elect to be subject such provisions. The measure authorizes the Commission to adopt rules and regulations governing the arbitration process. The measure has a delayed effective date of January 1, 2021. This bill incorporates HB 58, HB 189, HB 901, HB 1494, and HB 1546 and is identical to SB 172.

us/states/va

Virginia General Assembly

2020

HB 1251

Virginia HB 1251 (2020)

bill

enacted

Luke E. Torian

2020-01-08

2020-04-10

openstates

ocd-bill/d1148803-64b9-46b1-9034-4982c3423383

https://lis.virginia.gov/cgi-bin/legp604.exe?201+sum+HB1251

4c7b9c8dd7d6d157339b5c7502e72676b9ad630ec0817c268c6dda5782bd2038

2026-07-01

https://data.openstates.org/daily/2026-07-01/public.pgdump

2026-07-06

reported

legislation

bill

us-va

Virginia HB 1251 (2020) — Health insurance; definitions, payment to out-of-network providers, emergency services.

Version chain

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

Acts of Assembly Chapter text (CHAP1080) (committee substitute) — source
Bill text as passed House and Senate (HB1251ER) (committee substitute) — source
Engrossed by House - committee substitute with amendments HB1251EH1 (committee substitute) — source
Engrossed by Senate - committee substitute HB1251S2 (committee substitute) — source
HB1251H2 (committee substitute) — source
Impact statement from DPB (HB1251S1) (committee substitute) — source

Votes

Constitutional reading dispensed (40-Y 0-N) — 40–0 (pass) · upper
Reported from Commerce and Labor with substitute (13-Y 2-N) — 13–2 (pass) · upper
Reported from Labor and Commerce with substitute (22-Y 0-N) — 22–0 (pass) · lower
VOTE: Passage (94-Y 5-N) — 93–5 (pass) · lower
Reported from Finance and Appropriations (14-Y 0-N) — 14–0 (pass) · upper
Reported from Appropriations with substitute (22-Y 0-N) — 22–0 (pass) · lower
Referred from General Laws — 0–0 (fail) · lower
VOTE: Adoption (98-Y 0-N) — 97–0 (pass) · lower
Subcommittee recommends reporting with substitute (8-Y 0-N) — 8–0 (pass) · lower
Passed Senate with substitute (40-Y 0-N) — 40–0 (pass) · upper

Timeline

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

2020-01-08 Prefiled and ordered printed; offered 01/08/20 20102088D introduction
2020-01-08 Referred to Committee on General Laws referral-committee
2020-01-16 Impact statement from DPB (HB1251)
2020-01-16 Referred from General Laws
2020-01-16 Referred to Committee on Labor and Commerce referral-committee
2020-01-23 Assigned L & C sub: Subcommittee #2 referral-committee
2020-01-30 Subcommittee recommends reporting with substitute (8-Y 0-N)
2020-01-30 Subcommittee recommends referring to Committee on Appropriations
2020-02-04 Reported from Labor and Commerce with substitute (22-Y 0-N) committee-passage
2020-02-04 Referred to Committee on Appropriations referral-committee
2020-02-04 Committee substitute printed 20107376D-H1 substitution
2020-02-04 Incorporates HB1546 (Adams)
2020-02-04 Incorporates HB1494 (Bagby)
2020-02-04 Incorporates HB58 (Ware)
2020-02-06 Impact statement from DPB (HB1251H1)
2020-02-07 Committee substitute printed 20108018D-H2 substitution
2020-02-07 Incorporates HB1546 (Adams)
2020-02-07 Incorporates HB1494 (Bagby)
2020-02-07 Incorporates HB189 (Levine)
2020-02-07 Incorporates HB901 (Sickles)
2020-02-07 Incorporates HB58 (Ware)
2020-02-07 Reported from Appropriations with substitute (22-Y 0-N) committee-passage
2020-02-09 Read first time reading-1
2020-02-10 House committee, floor amendments and substitutes offered
2020-02-10 Read second time reading-2
2020-02-10 Committee Labor and Commerce substitute rejected 20107376D-H1
2020-02-10 Committee on Appropriations substitute agreed to 20108018D-H2
2020-02-10 Amendments by Delegate Torian agreed to amendment-passage
2020-02-10 Engrossed by House - committee substitute with amendments HB1251EH1
2020-02-10 Printed as engrossed 20108018D-EH1
2020-02-11 Read third time and passed House (94-Y 5-N) passage, reading-3
2020-02-11 VOTE: Passage (94-Y 5-N)
2020-02-12 Constitutional reading dispensed
2020-02-12 Referred to Committee on Commerce and Labor referral-committee
2020-02-20 Impact statement from DPB (HB1251EH1)
2020-02-24 Reported from Commerce and Labor with substitute (13-Y 2-N) committee-passage
2020-02-24 Committee substitute printed 20109073D-S1 substitution
2020-02-24 Rereferred to Finance and Appropriations referral-committee
2020-02-25 Impact statement from DPB (HB1251S1)
2020-03-02 Reported from Finance and Appropriations (14-Y 0-N) committee-passage
2020-03-04 Constitutional reading dispensed (40-Y 0-N)
2020-03-05 Floor substitute printed 20109579D-S2 (Favola)
2020-03-05 Read third time reading-3
2020-03-05 Committee substitute rejected 20109073D-S1
2020-03-05 Reading of substitute waived
2020-03-05 Substitute by Senator Favola agreed to 20109579D-S2
2020-03-05 Engrossed by Senate - committee substitute HB1251S2
2020-03-05 Passed Senate with substitute (40-Y 0-N) passage
2020-03-05 Senate substitute agreed to by House 20109073D-S1 (98-Y 0-N)
2020-03-05 VOTE: Adoption (98-Y 0-N)
2020-03-12 Enrolled
2020-03-12 Signed by Speaker
2020-03-12 Signed by President
2020-03-16 Impact statement from DPB (HB1251S2)
2020-03-16 Impact statement from DPB (HB1251ER)
2020-03-17 Enrolled Bill communicated to Governor on March 17, 2020
2020-03-17 Governor's Action Deadline 11:59 p.m., April 11, 2020
2020-04-10 Approved by Governor-Chapter 1080 (effective - see bill) executive-signature

Source

OpenStates / OpenCivicData bulk snapshot 2026-07-01; origin ocd-bill/d1148803-64b9-46b1-9034-4982c3423383. Confidence: reported (aggregated from official Virginia legislature records).

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