VirginiaHB7012026 Regular SessionHouseWALLET

Health and insurance; notice of adverse determination.

Sponsored By: Michelle Lopes Maldonado (Democratic)

Became Law

Summary

Health insurance; notice of adverse determination. Requires health carriers to send in writing to a covered person the notice of an adverse determination or final adverse determination and the covered person's right to request an external review, as required by current law, within five business days after the adverse determination or final adverse determination has been made. The bill also requires such notice to include certain information related to the person who made the adverse determination or final adverse determination.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

Faster provider notice and doctor review

Insurers must tell your treating provider in writing about a denial within two working days. If the prescription is for cancer pain, the provider must also get a phone call within 24 hours. Before a denial, the insurer must try in good faith to get information from the provider. The provider can review medical necessity with a physician advisor or peer before the decision. For cancer pain prescriptions, a physician advisor must review medical necessity with the provider. The written notice must explain how to ask for reconsideration and an appeal, and list a contact name, address, and phone number.

Quick notice and stronger external review rights

Your health carrier must notify you in writing within five business days after any denial or final denial. The notice must highlight your right to external review and list contacts (for HMOs, the medical director; for other plans, the internal-appeal contact) and the provider who made the decision. It must explain when you can ask for expedited external review: cancer or other conditions where delay risks life, health, or recovery; and experimental or investigational denials when your doctor certifies fast treatment is needed. You may file an expedited external review while filing an expedited internal appeal; the independent review organization decides the order. If a standard internal appeal has no written decision in 30 days and there was no agreed delay, you can go straight to external review and are treated as having finished the internal appeal. For final denials about admission, availability of care, continued stay, or emergency care before discharge, you may request expedited review. The carrier must include the standard and expedited external review steps and any required forms with the notice.

Sponsors & Cosponsors

Sponsor

  • Michelle Lopes Maldonado

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 493 • No: 0

House vote 3/12/2026

Senate amendment agreed to by House

Yes: 98 • No: 0

Senate vote 3/11/2026

Passed Senate with amendment Block Vote

Yes: 39 • No: 0

Senate vote 3/11/2026

Commerce and Labor Amendment agreed to

Yes: 0 • No: 0

Senate vote 3/11/2026

Reconsideration of Senate passage agreed to by Senate Block Vote

Yes: 40 • No: 0

Senate vote 3/11/2026

Passed Senate with amendment 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 Commerce and Labor with amendment

Yes: 14 • No: 0

House vote 2/11/2026

Passed House Block Vote

Yes: 98 • No: 0

House vote 2/11/2026

Read third time and passed House Block Vote

Yes: 96 • No: 0

House vote 2/5/2026

Reported from Labor and Commerce with substitute

Yes: 22 • No: 0

House vote 2/3/2026

Subcommittee recommends reporting with substitute

Yes: 9 • No: 0 • Other: 1

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0411)

    4/8/2026Governor
  2. Approved by Governor-Chapter 411 (effective 7/1/2026)

    4/8/2026Governor
  3. Governor's Action Deadline 11:59 p.m., April 13, 2026

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

    3/31/2026House
  5. Signed by Speaker

    3/31/2026House
  6. Bill text as passed House and Senate (HB701ER)

    3/30/2026House
  7. Enrolled

    3/30/2026House
  8. Signed by President

    3/30/2026Senate
  9. Senate amendment agreed to by House (98-Y 0-N 0-A)

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

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

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

    3/11/2026Senate
  13. Commerce and Labor Amendment agreed to

    3/11/2026Senate
  14. Engrossed by Senate as amended

    3/11/2026Senate
  15. Read third time

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

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

    3/10/2026Senate
  18. Rules suspended

    3/10/2026Senate
  19. Senate committee offered

    3/9/2026Senate
  20. Fiscal Impact Statement from State Corporation Commission (HB701)

    3/9/2026House
  21. Reported from Commerce and Labor with amendment (14-Y 0-N)

    3/9/2026Senate
  22. Referred to Committee on Commerce and Labor

    2/12/2026Senate
  23. Constitutional reading dispensed (on 1st reading)

    2/12/2026Senate
  24. Passed House Block Vote (98-Y 0-N 0-A)

    2/11/2026House
  25. Reconsideration of passage agreed to by House

    2/11/2026House

Bill Text

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