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