VirginiaHB6062026 Regular SessionHouseWALLET

Medical care facility data reporting; value of charity care, gross patient charges, report.

Sponsored By: Rodney T. Willett (Democratic)

Became Law

Summary

Medical care facility data reporting; value of charity care. Removes certain limitations on the meaning of "reviewable service" as it relates to data reporting requirements for medical care facilities and specifies that the value of charity care for such reporting shall be based on gross patient charges. The bill directs the State Health Commissioner to submit an annual report to the Governor and General Assembly regarding charity care at medical facilities that are required to satisfy a condition of a certificate of public need.

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Bill Overview

Analyzed Economic Effects

7 provisions identified: 3 benefits, 0 costs, 4 mixed.

Stronger charity care and access rules

The law ties new facility approvals to access and charity care. Approved facilities must accept patients with Medicare, Medicaid, and TRICARE. Each facility must have a clear financial help policy, give it at admission or discharge, include it with bills to uninsured patients, and post it on-site and online. Except nursing homes, the value of charity care uses the Medicare billing method based on DRG/CPT codes and gross charges. For psychiatric projects, the Commissioner can require acceptance of people under involuntary temporary detention. If a facility cannot meet conditions directly, the Department can approve a plan that may include payments to approved groups or other steps.

Public reports on charity care and debt

Facilities with certificate conditions must report charity care totals, patient counts, services, and each service’s share, using DRG/CPT codes and gross charges to value care. Every hospital must report each year how much charity, discounted care, and other financial help it provided, and how much bad debt, including debt from payment plans. Other medical facilities that provide charity care must also report yearly amounts (nursing homes and those already reporting under conditions are excepted). Hospitals that receive disproportionate‑share (DSH) payments must report Medicaid inpatient days and total DSH amounts. By December 1 each year, the Commissioner publishes a report showing total charity charges, the cost using each hospital’s cost‑to‑charge ratio, charity care as a share of operating expenses, counts of applications (submitted, approved, denied), charity care by income level as a percent of the federal poverty level, and bad‑debt amounts and ratios.

Faster approvals and emergency bed flex

The Board sets faster, clearer reviews for new medical service approvals, including batching related radiation therapy and imaging projects. An expedited track finishes reviews within 90 days and allows four filing cycles each year; psychiatric bed additions are capped at 10 beds or 10% of beds, whichever is greater, with a two‑year lookback on prior awards. The Commissioner can exempt projects that face real market competition or have no effect on cost or quality. During declared disasters or emergency orders, hospitals and nursing homes can add temporary beds if they can staff them safely, for the emergency period plus 30 days. To run the program, the Board may charge application and registration fees.

Broader health provider data reporting

All health care providers must submit data the Board requires, including data from parent and subsidiary companies that operate in Virginia. Facilities that offer listed reviewable services (such as CT, MRI, PET, radiation therapy, transplants, psychiatric or substance‑abuse treatment, and more) must report how often those services are used. Continuing care retirement communities with nursing beds must report use of those beds. A facility that fails to report can be fined up to $100 per day per violation; fines go to the Literary Fund. Every two years, the Board reviews whether the data collection program is working.

HMO quality scores for consumers

HMOs must submit audited quality and performance data each year using HEDIS or other Board‑approved measures so shoppers can compare plans. The Commissioner may waive HEDIS reporting if an HMO meets Board exemption rules. The Commissioner contracts with an authorized nonprofit to compile and share the data and to help set and review the quality measures.

Tighter project cost caps and fines

The Commissioner can require a completion schedule and a maximum capital cost when approving a project. The Department monitors progress and can revoke a certificate for lack of progress or overspending. Breaking certificate conditions can bring civil fines up to $100 per violation per day until the project is finished. The Commissioner may also approve cost increases above 20% of the authorized capital cost when the increase is reasonable, necessary, and does not materially expand the project.

Regular review of charity‑care conditions

When checking a plan to meet certificate conditions, the Department counts only actions taken after the conditioned certificate is issued. The Commissioner reviews each conditioned certificate at least every three years, tells the facility if conditions should change, and explains how to request amendments. The Commissioner must consider changes in how care is paid for and delivered, including Medicaid changes, and the facility’s specific situation.

Sponsors & Cosponsors

Sponsor

  • Rodney T. Willett

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 398 • No: 15

House vote 3/12/2026

Senate substitute agreed to by House

Yes: 93 • No: 5

Senate vote 3/11/2026

Passed Senate with substitute Block Vote

Yes: 40 • No: 0

Senate vote 3/11/2026

Finance and Appropriations Substitute agreed to

Yes: 0 • No: 0

Senate vote 3/11/2026

Passed Senate with substitute Block Vote

Yes: 39 • No: 0

Senate vote 3/11/2026

Reconsideration of Senate passage agreed to by Senate Block Vote

Yes: 40 • No: 0

Senate vote 3/10/2026

Constitutional reading dispensed Block Vote (on 2nd reading)

Yes: 37 • No: 0

Senate vote 3/10/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 3/9/2026

Reported from Finance and Appropriations with substitute

Yes: 14 • No: 0

Senate vote 2/26/2026

Reported from Education and Health and rereferred to Finance and Appropriations

Yes: 15 • No: 0

House vote 2/4/2026

Read third time and passed House

Yes: 88 • No: 10

House vote 1/29/2026

Reported from Health and Human Services

Yes: 22 • No: 0

House vote 1/27/2026

Subcommittee recommends reporting

Yes: 10 • No: 0

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0408)

    4/8/2026Governor
  2. Approved by Governor-Chapter 408 (effective 7/1/2026)

    4/8/2026Governor
  3. Fiscal Impact Statement from Department of Planning and Budget (HB606)

    3/31/2026House
  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 (HB606ER)

    3/30/2026House
  8. Enrolled

    3/30/2026House
  9. Signed by President

    3/30/2026Senate
  10. Fiscal Impact Statement from Department of Planning and Budget (HB606)

    3/12/2026House
  11. Senate substitute agreed to by House (93-Y 5-N 0-A)

    3/12/2026House
  12. Passed Senate with substitute Block Vote (40-Y 0-N 0-A)

    3/11/2026Senate
  13. Reconsideration of Senate passage agreed to by Senate Block Vote (40-Y 0-N 0-A)

    3/11/2026Senate
  14. Passed Senate with substitute Block Vote (39-Y 0-N 0-A)

    3/11/2026Senate
  15. Finance and Appropriations Substitute agreed to

    3/11/2026Senate
  16. Engrossed by Senate - committee substitute

    3/11/2026Senate
  17. Read third time

    3/11/2026Senate
  18. Passed by for the day Block Vote (Voice Vote)

    3/10/2026Senate
  19. Constitutional reading dispensed Block Vote (on 2nd reading) (37-Y 0-N 0-A)

    3/10/2026Senate
  20. Committee substitute printed 26109441D-S1

    3/10/2026Senate
  21. Rules suspended

    3/10/2026Senate
  22. Reported from Finance and Appropriations with substitute (14-Y 0-N)

    3/9/2026Senate
  23. Reported from Education and Health and rereferred to Finance and Appropriations (15-Y 0-N)

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

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

    2/5/2026Senate

Bill Text

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