VirginiaHB6032026 Regular SessionHouseWALLET

Virginia All-Payer Claims Database; disclosure of information, limitation.

Sponsored By: Rodney T. Willett (Democratic)

Became Law

Summary

Virginia All-Payer Claims Database; disclosure of information; limitation. Specifies that the nonprofit organization facilitating the administration of the Virginia All-Payer Claims Database shall not disclose information relating to reimbursement beyond what is otherwise publicly available. Under current law, provisions against disclosure are not limited to information that is not otherwise publicly available.

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Bill Overview

Analyzed Economic Effects

7 provisions identified: 4 benefits, 1 costs, 2 mixed.

Fines for late APCD data reporting

If a private data supplier misses a reporting deadline and does not make a good‑faith effort after written notice, the Board can fine them. The nonprofit must give written notice first. If they fail to respond within two weeks, fines can be up to $1,000 per week per violation, capped at $50,000 per violation. The Department keeps these fines to improve the APCD.

Strong privacy and control of APCD data

APCD data is confidential and exempt from Virginia FOIA. A data release committee must approve access, with releases limited to aggregate counts over 10, de‑identified data, or limited data sets. Public releases use a masked proxy for reimbursements; only limited, approved reports may use actual amounts. Any report that names a provider or is 60% or more from one provider or payer gets a 30‑day review before release. The nonprofit uses standard data agreements, a common data layout, and avoids sharing provider‑specific reimbursement rates. The Department is set up as a HIPAA health oversight agency, and an advisory committee with balanced members helps guide the APCD.

Free APCD data for state agencies

The nonprofit, the Department of Health, the Department of Medical Assistance Services, and the Bureau of Insurance get free access to APCD data. They may use it only for public health improvement research and activities.

Virginia creates statewide health claims database

The law creates a statewide All-Payer Claims Database. Insurers and third-party administrators with at least 1,000 covered Virginia lives must report paid claims. Medicaid (DMAS) and state and local plans report, and federal plans report as allowed by law. ERISA plans report only when an employer opts in. Dental, vision, Medigap, disability income, workers’ comp, standard long-term care, and disease-specific plans are excluded. The data supports public health tracking, comparisons of cost and quality, and testing new care and payment models.

ERISA employers can opt in; TPA rules

Employers with ERISA health plans can choose to share their claims data in the APCD. When an employer opts in, its TPA must start reporting next reporting period and keep reporting until the employer opts out. Employers may opt out with written notice at least 30 days before the next reporting period. TPAs do not have to submit claims processed before they signed their service contract. Each year by January 31, TPAs must file lists of ERISA plans that opted in and employers they serve; these lists are proprietary and FOIA‑exempt.

Plan funding to sustain the APCD

The Commissioner and the nonprofit board must make short‑ and long‑term plans to fund APCD operations beyond state appropriations. The law does not provide money or set new fees. It requires planning that may recommend other funding sources.

No APCD fees on practitioners

No one can charge a health care practitioner a required fee to form or run the APCD. The nonprofit may charge a reasonable fee only if a practitioner chooses to access the database for reasons other than checking their own data.

Sponsors & Cosponsors

Sponsor

  • Rodney T. Willett

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 211 • No: 0

Senate vote 3/2/2026

Passed Senate Block Vote

Yes: 40 • No: 0

Senate vote 2/27/2026

Constitutional reading dispensed Block Vote (on 2nd reading)

Yes: 37 • No: 0

Senate vote 2/27/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 2/26/2026

Reported from Education and Health

Yes: 15 • No: 0

House vote 1/28/2026

Read third time and passed House Block Vote

Yes: 97 • No: 0

House vote 1/22/2026

Reported from Health and Human Services

Yes: 22 • No: 0

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0639)

    4/13/2026Governor
  2. Approved by Governor-Chapter 639 (effective 7/1/2026)

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

    3/10/2026Governor
  4. Enrolled Bill communicated to Governor on March 10, 2026

    3/10/2026House
  5. Fiscal Impact Statement from Department of Planning and Budget (HB603)

    3/6/2026House
  6. Bill text as passed House and Senate (HB603ER)

    3/6/2026House
  7. Enrolled

    3/6/2026House
  8. Signed by President

    3/6/2026Senate
  9. Signed by Speaker

    3/6/2026House
  10. Passed Senate Block Vote (40-Y 0-N 0-A)

    3/2/2026Senate
  11. Read third time

    3/2/2026Senate
  12. Passed by for the day Block Vote (Voice Vote)

    2/27/2026Senate
  13. Constitutional reading dispensed Block Vote (on 2nd reading) (37-Y 0-N 0-A)

    2/27/2026Senate
  14. Rules suspended

    2/27/2026Senate
  15. Reported from Education and Health (15-Y 0-N)

    2/26/2026Senate
  16. Assigned Education sub: Health

    2/24/2026Senate
  17. Referred to Committee on Education and Health

    1/29/2026Senate
  18. Constitutional reading dispensed (on 1st reading)

    1/29/2026Senate
  19. Read third time and passed House Block Vote (97-Y 0-N 0-A)

    1/28/2026House
  20. Read second time and engrossed

    1/27/2026House
  21. Read first time

    1/26/2026House
  22. Reported from Health and Human Services (22-Y 0-N)

    1/22/2026House
  23. Fiscal Impact Statement from Department of Planning and Budget (HB603)

    1/15/2026House
  24. Referred to Committee on Health and Human Services

    1/13/2026House
  25. Prefiled and ordered printed; Offered 01-14-2026 26101882D

    1/13/2026House

Bill Text

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