VirginiaSB5242026 Regular SessionSenateWALLET

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

Sponsored By: R. Creigh Deeds (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 HB 656.

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 4 benefits, 0 costs, 1 mixed.

Stronger mental health coverage and oversight

Health plans must cover mental health and substance use care the same as medical care for kids, teens, and adults. Plans must cover mobile crisis response and residential stabilization like the same services in other settings. Reviews must follow generally accepted care standards, not stricter rules. Insurers must file parity analyses at least every two years and share data on denials, prior authorizations, networks, and pay. The Bureau can post reports, open exams, and fine up to $100,000 per violation or order fixes. By October 1, 2026, carriers must submit current analyses; starting December 1, 2027 and every odd year, the Bureau posts a public report. Some definition updates take effect July 1, 2027.

New network access rules for managed care

The Board of Health must set numeric standards for timely access, travel time, and distance for managed care plans. These standards must be at least as strict as those for qualified health and dental plans. The Board must adopt the rules within 280 days. The Board can later align updates to exchange standards faster, with public comment.

Statewide health claims database for comparisons

Virginia creates an All‑Payer Claims Database to collect paid health claims and support cost and quality comparisons. Insurers, HMOs, large TPAs (1,000+ covered lives), and government plans submit data when allowed by law. The operator sets standard agreements, data fields, and national data layouts. The database supports comparisons by place, demographics, and peer groups, and publishes plan‑level analyses. The APCD does not collect Medigap, workers’ comp, disability income, standard long‑term care, disease‑specific, dental, or vision claims.

Minimum mental health benefits for older small-group plans

If you are in a grandfathered small‑group plan, adults get at least 20 inpatient days a year. Children and teens get at least 25 inpatient days. Up to 10 inpatient days can convert to partial hospitalization at 1.5 partial days per 1 inpatient day. Plans must cover at least 20 outpatient visits a year. After the first five outpatient visits, you pay at least 50% coinsurance; medication management visits do not count toward the 20‑visit cap. Outpatient visits that go to your deductible do not count against the visit limit.

Privacy and fairness rules for claims database

The APCD operator must protect patient data under HIPAA and HITECH, and the Department acts as a health oversight agency. Provider, facility, and insurer reimbursement amounts cannot be publicly released, and methods must follow national standards or be fully explained. A broad advisory committee guides the APCD, appointments must avoid conflicts, meetings are public, and the operator reports to the committee each year.

Sponsors & Cosponsors

Sponsor

  • R. Creigh Deeds

    Democratic • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 425 • No: 45

House vote 3/13/2026

Conference report agreed to by House

Yes: 93 • No: 1

Senate vote 3/13/2026

Conference report agreed to by Senate

Yes: 38 • No: 0

Senate vote 3/6/2026

Senate acceded to request Block Vote

Yes: 40 • No: 0

Senate vote 3/3/2026

House substitute rejected by Senate

Yes: 0 • No: 40

House vote 2/27/2026

Passed House with substitute

Yes: 92 • No: 4

House vote 2/24/2026

Reported from Health and Human Services with substitute

Yes: 21 • No: 0 • Other: 1

Senate vote 2/16/2026

Constitutional reading dispensed Block Vote (on 3rd reading)

Yes: 39 • No: 0

Senate vote 2/16/2026

Finance and Appropriations Substitute agreed to

Yes: 0 • No: 0

Senate vote 2/16/2026

Education and Health Substitute rejected

Yes: 0 • No: 0

Senate vote 2/16/2026

Read third time and passed Senate Block Vote

Yes: 39 • No: 0

Senate vote 2/13/2026

Constitutional reading dispensed Block Vote (on 1st reading)

Yes: 35 • No: 0

Senate vote 2/12/2026

Reported from Finance and Appropriations with substitute

Yes: 13 • No: 0

Senate vote 2/5/2026

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

Yes: 15 • No: 0

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0653)

    4/13/2026Governor
  2. Approved by Governor-Chapter 653 (Effective - see bill)

    4/13/2026Governor
  3. Fiscal Impact Statement from Department of Planning and Budget (SB524)

    3/31/2026Senate
  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

    3/31/2026Senate
  6. Signed by Speaker

    3/31/2026House
  7. Bill text as passed Senate and House (SB524ER)

    3/30/2026Senate
  8. Enrolled

    3/30/2026Senate
  9. Signed by President

    3/30/2026Senate
  10. Conference report agreed to by House (93-Y 1-N 0-A)

    3/13/2026House
  11. Conference report agreed to by Senate (38-Y 0-N 0-A)

    3/13/2026Senate
  12. Conference Report released

    3/12/2026
  13. House Conferees: Willett, Gardner, Cherry

    3/11/2026House
  14. Conferees appointed by House

    3/11/2026House
  15. Senate acceded to request Block Vote (40-Y 0-N 0-A)

    3/6/2026Senate
  16. Senate Conferees: Deeds, Favola, Pillion

    3/6/2026Senate
  17. Conferees appointed by Senate

    3/6/2026Senate
  18. House requested conference committee

    3/4/2026House
  19. House insisted on substitute

    3/4/2026House
  20. House substitute rejected by Senate (0-Y 40-N 0-A)

    3/3/2026Senate
  21. Passed House with substitute (92-Y 4-N 0-A)

    2/27/2026House
  22. Engrossed by House - committee substitute

    2/27/2026House
  23. committee substitute agreed to

    2/27/2026House
  24. Read third time

    2/27/2026House
  25. Read second time

    2/26/2026House

Bill Text

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