All Roll Calls
Yes: 457 • No: 3
Sponsored By: Irene Shin (Democratic)
Signed by Governor
Health insurance; ethics and fairness in carrier business practices; downcoded claims. Prohibits a carrier, intermediary, administrator, or representative of a carrier from downcoding a claim unless the decision to downcode is determined by a person or electronic system that reflects correct coding standards and considers all relevant patient data from the billing provider in making the determination. The bill requires a carrier, intermediary, administrator, or representative that downcodes a claim to provide certain notice to the provider. The bill requires that all downcoding dispute decisions are reviewed and adjudicated by a natural person.
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14 provisions identified: 10 benefits, 1 costs, 3 mixed.
Carrier-provider contracts must bar discrimination solely because an enrollee is suing, or may sue, over a motor vehicle accident. This does not require treatment when the enrollee threatened or brought a professional-liability claim or regulatory complaint against the provider or specified related people. The Commission may refer patterns of possible violations without corrective action to the Board of Medicine or Health Commissioner. It may first let the provider correct or explain the conduct. Those officials may impose fines, recover costs, or take other authorized action, and must report results to the Commission.
Beginning January 1, 2027, carriers must respond to expedited care-approval requests within 72 hours, including weekends. Standard requests have a seven-calendar-day deadline. Responses must approve, deny, or identify missing information; completed additions trigger the same deadline for a final decision. Denial reasons must reach the provider or designated contact electronically or by phone within those deadlines. Carriers generally cannot change approvals after care is scheduled or provided as approved. Exceptions cover provider-requested changes, fraud or misrepresentation, specified federal or manufacturer actions, and loss of plan enrollment.
Beginning January 1, 2027, carriers must publicly post care-approval services, codes, procedures, forms, and effective dates in one electronic location. Providers must get at least 30 calendar days’ notice of changes, and postings must be updated when changes start. Advance notice is not required when approval requirements are removed during a pandemic, disaster, or other emergency. Older requirements may list January 1, 2027, as their effective date. Carriers cannot deny claims for missing approval when the requirements on the service date were not properly posted.
Virginia’s fair-business rules cover more licensed entities that offer managed-care plans or arrange health services regulated as insurance. Carriers and providers remain responsible for covered duties when vendors or subcontractors do the work.
Carriers must identify and explain a paid claim in writing before denying it afterward or seeking repayment. Recovery requires fraud, duplicate payment, services not delivered, or payment made no more than 12 months earlier. A written agreement can allow withholding or offset after 12 months, with at least 30 days’ advance notice. Required communications and provider responses must be electronic by January 1, 2026, using a contract-agreed method and location.
Carriers must disclose payment methods that charge providers transaction, processing, or similar fees in provider contracts. This includes methods used by payment agents. Carriers must offer a fee-free option. They must use it when the provider chooses it and supplies the required enrollment information.
Carriers may lower a claim’s service code only through a person or system using correct coding standards and relevant patient data. They must notify providers and identify the adjustment and payment-explanation codes. Providers get at least 180 days to dispute coding reductions, human review of every dispute decision, and reasonable review and appeal deadlines. They may group disputes for one patient, following their contract and federal health privacy rules. These coding protections exclude limited-scope benefits, including stand-alone dental plans. Carriers must also offer a written process for claim-payment disputes; an overturned denial becomes a clean claim on the decision date.
Carriers must pay provider-contract claims within 40 days of receipt when payment is reasonably clear. Supported disputes about claims, eligibility, another payer, or fraud can delay payment. Carriers must keep receipt-date records that claim submitters can inspect. A clean claim includes provider and patient details, service codes, diagnoses, date and place, required authorization proof, and contract-required records. Carriers must report defects and request missing information within 30 days; payment deadlines apply after that information arrives. Missing the notice deadline makes a claim clean, and generally bars refusing covered-service payment unless the submitter materially caused the notice failure. Claim-defect notices and information must be electronic by January 1, 2026. Interest owed must be paid without a demand, with claim payment or within 60 days afterward, unless due sooner.
Carriers must provide applicable fee schedules, payment methods, and material contract documents before providers sign. They must offer ways to check coverage, medical need, authorization, reimbursement, coding, and claim-processing rules. Contracts must disclose routine claim combining or coding reductions; requested policies are due within 10 business days. When copyright blocks sharing a policy, carriers must clearly explain how it applies. Applicable contract or policy changes require 60 calendar days’ advance notice. Providers have 30 calendar days after receiving changes to give notice that they will leave at the earliest contract-allowed date.
Carriers must pay for services they approved or confirmed in advance as medically needed and covered. Exceptions include unsupported claims, another responsible payer, prior payment, fraud, major wrong information, and certain ineligible enrollees. Fraud found after care can also justify denial. When new clinical evidence changes an approved invasive procedure or surgery, carriers must pay for qualifying less or more extensive care. Changed care must be medically needed, covered, not investigative, correctly coded, and submitted under the carrier’s claim rules.
The law’s prior-approval section does not cover certain health maintenance organizations. The plan must contract with a multispecialty physician group whose doctors are both employees and shareholders. The group may also contract with community providers. The plan must provide and arrange physician services through group members or those contracted providers. Enrollees in these qualifying plans do not receive that section’s protections.
Carriers must maintain an electronic connection for providers’ approval requests for medical items and services, following federal standards. The deadline is January 1, 2027, unless the Centers for Medicare and Medicaid Services sets a later date. Federal enforcement delays or suspensions can also move that deadline. Within one year of the required carrier start date, participating providers must make their health-record systems able to connect. Providers may request an undue-hardship waiver for a period set by the appropriate Virginia health regulatory agency.
Providers harmed by carrier violations or breaches of required contract terms may sue for actual losses. A finding of gross negligence and willful conduct allows up to three times actual losses; legal fees and court costs may also be awarded. Each affected claim counts separately, and carriers, networks, panels, and intermediaries cannot punish providers for asserting legal or contract rights. Before a late-payment complaint, providers must request a conference from the contract contact, supply supporting records, and document reasonable efforts. They generally must wait 30 calendar days, unless they judge the carrier unresponsive, and confirm compliance in the complaint. The Virginia State Corporation Commission oversees required contract terms and payment and defect-notice standards, but cannot decide individual disputes under this section.
Beginning July 1, 2025, carriers under Virginia State Corporation Commission oversight must offer providers electronic coverage checks. Carriers must also send provider contracts, amendments, and notices electronically by July 1, 2025. Providers must submit those materials electronically by January 1, 2026. Fax does not count. Both sides must put their agreed delivery method and location in the contract; coverage checks do not change eligibility.
Irene Shin
Democratic • House
There are no cosponsors for this bill.
All Roll Calls
Yes: 457 • No: 3
House vote • 4/22/2026
House concurred in Governor's recommendation
Yes: 99 • No: 1
Senate vote • 4/22/2026
Senate concurred in Governor's recommendation
Yes: 39 • No: 0
House vote • 3/2/2026
Senate substitute agreed to by House
Yes: 98 • No: 0
Senate vote • 2/26/2026
Commerce and Labor Substitute agreed to
Yes: 0 • No: 0
Senate vote • 2/26/2026
Passed Senate with substitute Block Vote
Yes: 40 • No: 0
Senate vote • 2/25/2026
Constitutional reading dispensed Block Vote (on 2nd reading)
Yes: 40 • No: 0
Senate vote • 2/25/2026
Passed by for the day Block Vote (Voice Vote)
Yes: 0 • No: 0
Senate vote • 2/23/2026
Reported from Commerce and Labor with substitute
Yes: 14 • No: 0
House vote • 2/11/2026
Read third time and passed House
Yes: 97 • No: 1
House vote • 2/5/2026
Reported from Labor and Commerce with substitute
Yes: 21 • No: 1
House vote • 2/3/2026
Subcommittee recommends reporting with substitute
Yes: 9 • No: 0
Senate concurred in Governor's recommendation (39-Y 0-N 0-A)
House concurred in Governor's recommendation (99-Y 1-N 0-A)
Acts of Assembly Chapter text (CHAP1055)
Approved by Governor-Chapter 1055 (effective 7/1/2026)
Signed by President
Signed by Speaker
Governor's recommendation adopted
Governor's recommendation received by House
Fiscal Impact Statement from State Corporation Commission (HB484)
Governor's Action Deadline 11:59 p.m., April 13, 2026
Enrolled Bill communicated to Governor on March 10, 2026
Bill text as passed House and Senate (HB484ER)
Enrolled
Signed by President
Signed by Speaker
Fiscal Impact Statement from State Corporation Commission (HB484)
Senate substitute agreed to by House (98-Y 0-N 0-A)
Passed Senate with substitute Block Vote (40-Y 0-N 0-A)
Commerce and Labor Substitute agreed to
Engrossed by Senate - committee substitute
Read third time
Passed by for the day Block Vote (Voice Vote)
Constitutional reading dispensed Block Vote (on 2nd reading) (40-Y 0-N 0-A)
Rules suspended
Committee substitute printed 26108293D-S1
Chaptered
4/22/2026
Reenrolled
4/22/2026
Gov Recommendation
4/13/2026
Enrolled
3/5/2026
Substitute
2/24/2026
Substitute
2/23/2026
Substitute
2/5/2026
Substitute
2/4/2026
Substitute
2/3/2026
Introduced
1/12/2026
HB5, Employment; paid sick leave, civil penalties.
Employment; paid sick leave; civil penalties; civil actions. Requires one hour of paid sick leave for every 30 hours worked for all employees of private employers and state and local governments, with certain exceptions. The bill requires that employees who are employed and compensated on a fee-for-service basis accrue paid sick leave in accordance with regulations adopted by the Commissioner of Labor and Industry. The bill provides that employees transferred to a separate division or location remain entitled to previously accrued paid sick leave and that employees retain their accrued paid sick leave under any successor employer. The bill allows employers to provide a more generous paid sick leave policy than prescribed by its provisions and specifies that employees, in addition to using paid sick leave for their physical or mental illness or to care for a family member, may use paid sick leave to seek or obtain certain services or to relocate or secure an existing home due to domestic abuse, sexual assault, or stalking. The bill requires the Commissioner to promulgate regulations for the implementation and enforcement of the bill's provisions by July 1, 2027.The bill authorizes the Commissioner, in the case of a knowing violation, to subject an employer to a civil penalty not to exceed $150 for the first violation, $300 for the second violation, and $500 for each successive violation. The Commissioner or Attorney General may commence administrative proceedings or bring a civil action to enforce the bill's provisions. Additionally, the bill authorizes an aggrieved employee to bring a civil action against the employer in which he may recover double the amount of any unpaid sick leave and the amount of any actual damages suffered as the result of the employer's violation. Certain provisions of the bill have a delayed effective date of July 1, 2027. This bill is identical to SB 199.
SB199, Employment; paid sick leave, civil penalties.
Employment; paid sick leave; civil penalties; civil actions. Requires one hour of paid sick leave for every 30 hours worked for all employees of private employers and state and local governments, with certain exceptions. The bill requires that employees who are employed and compensated on a fee-for-service basis accrue paid sick leave in accordance with regulations adopted by the Commissioner of Labor and Industry. The bill provides that employees transferred to a separate division or location remain entitled to previously accrued paid sick leave and that employees retain their accrued paid sick leave under any successor employer. The bill allows employers to provide a more generous paid sick leave policy than prescribed by its provisions and specifies that employees, in addition to using paid sick leave for their physical or mental illness or to care for a family member, may use paid sick leave to seek or obtain certain services or to relocate or secure an existing home due to domestic abuse, sexual assault, or stalking. The bill requires the Commissioner to promulgate regulations for the implementation and enforcement of the bill's provisions by July 1, 2027. The bill authorizes the Commissioner, in the case of a knowing violation, to subject an employer to a civil penalty not to exceed $150 for the first violation, $300 for the second violation, and $500 for each successive violation. The Commissioner or Attorney General may commence administrative proceedings or bring a civil action to enforce the bill's provisions. Additionally, the bill authorizes an aggrieved employee to bring a civil action against the employer in which he may recover double the amount of any unpaid sick leave and the amount of any actual damages suffered as the result of the employer's violation. Certain provisions of the bill have a delayed effective date of July 1, 2027. This bill incorporates SB 372 and is identical to HB 5.
HB95, Va. Residential Landlord and Tenant Act; landlord remedies, noncompliance with rental agreement.
Virginia Residential Landlord and Tenant Act; landlord remedies; noncompliance with rental agreement; payment plan. Requires a landlord who owns more than four rental dwelling units or more than a 10 percent interest in more than four rental dwelling units, before terminating a rental agreement due to nonpayment of rent if the exact amount of rent owed is less than or equal to one month's rent plus any late charges contracted for in the rental agreement and as provided by law, to serve upon such tenant a written notice informing the tenant of the exact amount due and owed and offer the tenant a payment plan under which the tenant must pay the exact amount due and owed in equal monthly installments over a period of the lesser of six months or the time remaining under the rental agreement. The bill prohibits the landlord from charging any additional late fees during the payment plan period in connection with the unpaid rental amount for which the tenant entered into the payment plan so long as the tenant makes timely payments in accordance with the terms of the payment plan. The bill also outlines the remedies a landlord has if a tenant fails to pay the exact amount due and owed or enter into a payment plan within five days of receiving notice or if a tenant enters into a payment plan and after such plan becomes effective fails to pay rent when due or fails to make a payment under the terms of the agreed-upon payment plan. The bill has a delayed effective date of January 1, 2027.
HB1393, Electric utilities; pilot program for energy assistance and weatherization for certain individuals.
Electric utilities; pilot programs for energy assistance and weatherization for certain individuals. Amends annual funding commitments for the purposes of the annual pilot program for energy assistance and weatherization for low-income, elderly, and disabled individuals conducted by Dominion Energy Virginia and Appalachian Power Company. Under the bill, Appalachian Power Company is required to continue its pilot program at no less than $1 million and no greater than $1.5 million annually. Dominion Energy Virginia is required to continue its pilot program at no less than $156 million and no greater than $204 million for the time period beginning July 1, 2026, and ending July 1, 2038. The bill extends the sunset date of such pilot programs from July 1, 2028, to July 1, 2038.The bill also provides that Dominion Energy Virginia may recover costs associated with certain electrical facilities that have been approved by the State Corporation Commission as of December 1, 2033, provided that certain requirements are met and notwithstanding any limitations on such cost recovery in current law. The bill directs Dominion Energy Virginia to propose to the Commission, in any proceeding to determine rates for generation and distribution services commencing after January 1, 2027, and before July 1, 2033, that certain costs related to capacity procurement requirements and distribution infrastructure investments are allocated to the utility's customer class approved to serve customers with a contracted or measured electric demand of 25 megawatts or greater and an anticipated or measured average annual electric load factor of 75 percent or greater. The bill provides that certain customers in manufacturing, industrial, or consumer goods warehousing and distribution activities other than data storage may elect to remain on their existing rate schedule. The bill requires Dominion Energy Virginia, in connection with its first proceeding to determine rates for generation and distribution services commencing after July 1, 2026, to include in its petition to the Commission a proposal to revise its tariff for supplementary, maintenance, or standby service for customers with power plants, effective as of January 1, 2028. The bill provides that the Commission shall only approve such proposal if it determines that such tariff will not adversely affect other retail customers or the utility in a manner contrary to the public interest, and any revised tariff terms shall include protections against stranded cost risks to the utility customer base. Additionally, the bill authorizes Dominion Energy Virginia to file a petition for the securitization of certain deferred fuel costs. The bill requires the Commission, in evaluating certain petitions, to require to the greatest extent it finds in the public interest the use of wages, salaries, benefits, and other remuneration to any mechanic, laborer, or worker employed, retained, or otherwise hired to perform services in connection with a contract contemplated pursuant to such petition at the prevailing wage rate and to the greatest extent practicable, the use of a skilled workforce through registered apprenticeship programs for any authorized demand flexibility programs, utility-related procurement through utility-owned or third-party providers, and an evaluation of other potential opportunities to develop Virginia's skilled workforce by requiring minimum apprenticeship program requirements for such electric generation or energy storage facility work. This bill incorporates HB 634.
HB834, Virginia Residential Landlord and Tenant Act; fire or casualty damage, termination by landlord.
Virginia Residential Landlord and Tenant Act; fire or casualty damage; termination by landlord. Requires a landlord, prior to giving a tenant 21 days' notice of his intention to terminate the rental agreement for a dwelling unit that has been damaged or destroyed by fire or casualty, to (i) make a reasonable effort to meet with the tenant to discuss reasonable alternatives and offer the tenant a substantially similar dwelling unit, if one is available, or (ii) determine that the damage was caused by the tenant's failure to maintain the dwelling unit in accordance with relevant law. Current law allows the landlord to terminate such agreement by giving the tenant 14 days' notice of his intention to terminate on the basis of the landlord's determination that such damage requires the removal of the tenant and that the use of the premises is substantially impaired. The bill requires the landlord, upon receiving a request from the tenant after the tenant has received such notice, to reevaluate the extent of damage and habitability of such dwelling unit unless the landlord has determined that the damage was caused by the tenant's failure to maintain the dwelling unit. The bill has a delayed effective date of January 1, 2027.
HB675, Protection of employees; coercion or threat based on immigration status, civil penalty.
Protection of employees; coercion or threat based on immigration status; civil penalty. Prohibits an employer, including the Commonwealth and its agencies and political subdivisions, from using coercion or issuing a threat to an employee based on immigration status in furtherance of committing a violation of the Virginia Minimum Wage Act or provisions related to the payment of wages. An aggrieved employee is permitted to file a complaint with the Commissioner of Labor and Industry within 180 days of the alleged coercive action or threat. The bill authorizes the Commissioner to investigate such complaints and, if the allegation is substantiated, to impose a civil penalty in the following amounts: (i) up to $5,000 for the first violation, (ii) up to $9,000 for the second violation, and (iii) up to $12,000 for any subsequent violation. The bill provides that any such penalty assessed shall be paid to the Commissioner for deposit into the General Fund. The bill also authorizes the Commissioner to seek injunctive relief as may be necessary for enforcement.