VirginiaHB4242026 Regular SessionHouseWALLET

Health insurance; definitions, prohibited restrictions on in-network referrals.

Sponsored By: Destiny LeVere Bolling (Democratic)

Became Law

Summary

Health insurance; prohibited restrictions on in-network referrals. Prohibits a health insurance carrier from prohibiting an in-network provider, as defined in the bill, from referring any enrollee or specimen to any in-network clinical laboratory or in-network pathology service provider under the terms of such insurance unless such referral would constitute a violation of certain laws. This bill is identical to SB 745.

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 2 benefits, 2 costs, 1 mixed.

Insurers cannot block in-network lab referrals

The law stops insurers from blocking your in-network doctor from sending you or your sample to any in-network lab or pathology provider under your plan. This applies only to in-network labs and providers. It does not protect referrals that break Virginia self-referral rules or the federal anti-kickback law.

Medicaid and CHIP get referral protection

If your Medicaid or CHIP plan is run by DMAS, your HMO cannot block in-network lab or pathology referrals. Your in-network doctor can send you or your specimen to any in-network lab. Referrals that break self-referral or anti-kickback laws are not protected.

State Commission won't hear referral disputes

You cannot bring an individual complaint about these referral limits to the State Corporation Commission. The Commission does not decide these disputes. You must use other enforcement or legal routes.

HMOs can deny out-of-area workers

An HMO that offers employer plans does not have to enroll an employee who lives outside its service area. If you live out of area, you may need a different plan from your job.

Virginia rules on HMO marketing and status

Virginia limits which insurance rules apply to licensed HMOs. When the law says “insurer,” it can include HMOs for the listed sections. HMOs can market and solicit enrollees without breaking health-professional ad rules. An HMO is not treated as practicing medicine, and individual providers must still follow medical laws.

Sponsors & Cosponsors

Sponsor

  • Destiny LeVere Bolling

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 334 • No: 1

Senate vote 3/10/2026

Passed Senate Block Vote

Yes: 40 • No: 0

Senate vote 3/9/2026

Constitutional reading dispensed Block Vote (on 2nd reading)

Yes: 40 • No: 0

Senate vote 3/9/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 3/6/2026

Reported from Finance and Appropriations

Yes: 14 • No: 0

Senate vote 2/23/2026

Reported from Commerce and Labor and rereferred to Finance and Appropriations

Yes: 14 • No: 0

House vote 2/4/2026

Passed House Block Vote

Yes: 98 • No: 0

House vote 2/4/2026

Read third time and passed House Block Vote

Yes: 97 • No: 1

House vote 1/29/2026

Reported from Labor and Commerce with substitute

Yes: 22 • No: 0

House vote 1/27/2026

Subcommittee recommends reporting with substitute

Yes: 9 • No: 0 • Other: 1

Actions Timeline

  1. Fiscal Impact Statement from State Corporation Commission (HB424)

    4/13/2026House
  2. Acts of Assembly Chapter text (CHAP0138)

    4/6/2026Governor
  3. Approved by Governor-Chapter 138 (effective 7/1/2026)

    4/6/2026Governor
  4. Governor's Action Deadline 11:59 p.m., April 13, 2026

    3/31/2026Governor
  5. Enrolled Bill communicated to Governor on March 31, 2026

    3/31/2026House
  6. Signed by Speaker

    3/31/2026House
  7. Bill text as passed House and Senate (HB424ER)

    3/30/2026House
  8. Enrolled

    3/30/2026House
  9. Signed by President

    3/30/2026Senate
  10. Passed Senate Block Vote (40-Y 0-N 0-A)

    3/10/2026Senate
  11. Read third time

    3/10/2026Senate
  12. Passed by for the day Block Vote (Voice Vote)

    3/9/2026Senate
  13. Constitutional reading dispensed Block Vote (on 2nd reading) (40-Y 0-N 0-A)

    3/9/2026Senate
  14. Rules suspended

    3/9/2026Senate
  15. Reported from Finance and Appropriations (14-Y 0-N)

    3/6/2026Senate
  16. Fiscal Impact Statement from State Corporation Commission (HB424)

    3/3/2026House
  17. Reported from Commerce and Labor and rereferred to Finance and Appropriations (14-Y 0-N)

    2/23/2026Senate
  18. Referred to Committee on Commerce and Labor

    2/5/2026Senate
  19. Constitutional reading dispensed (on 1st reading)

    2/5/2026Senate
  20. Passed House Block Vote (98-Y 0-N 0-A)

    2/4/2026House
  21. Reconsideration of passage agreed to by House

    2/4/2026House
  22. Read third time and passed House Block Vote (97-Y 1-N 0-A)

    2/4/2026House
  23. Engrossed by House - committee substitute

    2/3/2026House
  24. committee substitute agreed to

    2/3/2026House
  25. Read second time

    2/3/2026House

Bill Text

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