VirginiaHB6562026 Regular SessionHouseWALLET

Mental health & substance abuse disorders; network adequacy standards, comparative analyses.

Sponsored By: Rodney T. Willett (Democratic)

Became Law

Summary

Mental health and substance abuse disorders; network adequacy standards; comparative analyses; report; emergency regulations. Directs the Department of Health to issue regulations that include quantitative network adequacy standards for timely access to care, travel time, and geographical distance that are at least as stringent as those imposed for qualified health plans and qualified dental plans. The bill amends the definitions of "mental health services" and "substance abuse services" for the purposes of health insurance coverage. The bill requires health carriers to submit all comparative analyses prepared pursuant to federal law to the Bureau of Insurance on the date and frequency as specified by the Bureau and includes additional information to include in such submission. Under the bill, the Bureau may impose a penalty not to exceed $100,000 for a noncompliant or insufficient comparative analysis or require a carrier to remove, revise, or remedy noncompliant treatment limitations. The bill also amends the contents of the annual report submitted by the Bureau to the General Assembly to cover enforcement efforts with respect to the federal Mental Health Parity and Addiction Equity Act of 2008.The bill authorizes the Bureau to promulgate regulations as necessary to implement the provisions of the bill and directs the Department of Health to adopt emergency regulations to implement the provisions of the bill. The bill directs the Department of Human Resource Management to evaluate the impact of the proposed changes to the provisions of the bill related to health insurance. The provisions of the bill related to health insurance have a delayed effective date of July 1, 2027. This bill is identical to SB 524.

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Bill Overview

Analyzed Economic Effects

8 provisions identified: 7 benefits, 0 costs, 1 mixed.

Mental health care covered like medical

The law requires health plans to cover mental health and substance use care the same as medical care. It applies when a policy is delivered, renewed, reissued, extended, a term changes, or a premium is adjusted. Coverage includes mobile crisis teams and services in crisis receiving centers and residential crisis units. The rule takes effect July 1, 2027. The Department of Human Resource Management must report by November 1, 2026 on impacts and costs for state employee plans.

Better access standards for plan networks

The Board of Health sets measurable network standards for managed care plans. Standards cover timely appointments, travel time, and distance. They must be at least as strict as the Virginia exchange’s plan standards. Rules must be in place within 280 days of enactment.

Rules for grandfathered small group coverage

If your small group plan is grandfathered, it may follow set minimums instead of full parity. Adults get at least 20 inpatient days a year; children and teens get at least 25. Up to 10 inpatient days can be converted to partial hospitalization at a rate of at least 1.5 partial days per inpatient day. Plans must cover at least 20 outpatient visits a year, with the plan paying at least 50% after the first five. Medication management and deductible‑only visits do not count toward the 20‑visit cap. Limits cannot be stricter than for other illnesses. These rules start July 1, 2027 and do not apply to excepted benefits or Medicare‑like/government plans.

Stronger parity oversight and transparency

Insurers must submit their parity comparative analyses by October 1, 2026, and then at least every two years. They must include numbers on denials, prior authorizations, appeals, out‑of‑network claims, review frequency, reimbursement by specialty, network metrics, credentialing time, and directory updates. The Bureau of Insurance can require fixes and fine up to $100,000 per violation. Starting December 1, 2027, and every odd year, the Bureau publishes a plain‑language report on analyses and enforcement.

Strong privacy and fair APCD access

The APCD uses standard data agreements that protect privacy under HIPAA and state law. It does not disclose provider, facility, or carrier‑specific payments or data that can reveal them. Data releases need committee approval and are limited to aggregates (counts over 10), de‑identified, or approved limited datasets. If a report names a provider or one provider or payer makes up 60% of the data, they get 30 days to review and correct before release. An advisory committee and a data release committee oversee use. State health agencies get free access for public health. Practitioners cannot be charged APCD formation or operating costs; only a reasonable fee for voluntary access not tied to verification.

Virginia creates health claims database

The state creates an All‑Payer Claims Database to study access, cost, and quality. A nonprofit runs it with the Commissioner to support public health, compare quality, and test payment models. The program can add data sources over time with stakeholder input.

Who must send claims data, penalties

Insurers, HMOs, and subscription plans with 1,000+ covered lives must submit paid claims data. TPAs for non‑ERISA plans with 1,000+ Virginia lives must report; Medicaid and government plans report as allowed by law. ERISA employers can opt in; they can opt out with 30 days’ notice before the next reporting period. TPAs must file annual opt‑in lists by January 31. If a data supplier ignores a written notice and does not make a good‑faith effort within two weeks, the Board can fine up to $1,000 per week per violation, capped at $50,000 per violation.

Streamlined rulemaking for some actions

Some agency rules, like internal procedures, price‑setting, technical fixes, and conforming changes, are exempt from certain state notice rules. This speeds limited, technical actions and does not change your benefits directly.

Sponsors & Cosponsors

Sponsor

  • Rodney T. Willett

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 324 • No: 11

House vote 3/11/2026

Senate substitute agreed to by House

Yes: 92 • No: 6

Senate vote 3/10/2026

Education and Health Substitute agreed to

Yes: 0 • No: 0

Senate vote 3/10/2026

Passed Senate with substitute 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 2/26/2026

Reported from Education and Health with substitute and rereferred to Finance and Appropriations

Yes: 15 • No: 0

House vote 2/16/2026

Read third time and passed House

Yes: 95 • No: 3

House vote 2/10/2026

Reported from Health and Human Services with substitute

Yes: 21 • No: 1

House vote 2/5/2026

Subcommittee recommends reporting with substitute

Yes: 7 • No: 1

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0652)

    4/13/2026Governor
  2. Approved by Governor-Chapter 652 (Effective - see bill)

    4/13/2026Governor
  3. Fiscal Impact Statement from Department of Planning and Budget (HB656)

    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 (HB656ER)

    3/30/2026House
  8. Enrolled

    3/30/2026House
  9. Signed by President

    3/30/2026Senate
  10. Senate substitute agreed to by House (92-Y 6-N 0-A)

    3/11/2026House
  11. Passed Senate with substitute Block Vote (40-Y 0-N 0-A)

    3/10/2026Senate
  12. Education and Health Substitute agreed to

    3/10/2026Senate
  13. Engrossed by Senate - committee substitute

    3/10/2026Senate
  14. Read third time

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

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

    3/9/2026Senate
  17. Rules suspended

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

    3/6/2026Senate
  19. Fiscal Impact Statement from Department of Planning and Budget (HB656)

    3/3/2026House
  20. Committee substitute printed 26108828D-S1

    2/27/2026Senate
  21. Reported from Education and Health with substitute and rereferred to Finance and Appropriations (15-Y 0-N)

    2/26/2026Senate
  22. Referred to Committee on Education and Health

    2/17/2026Senate
  23. Constitutional reading dispensed (on 1st reading)

    2/17/2026Senate
  24. Read third time and passed House (95-Y 3-N 0-A)

    2/16/2026House
  25. Fiscal Impact Statement from Department of Planning and Budget (HB656)

    2/16/2026House

Bill Text

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