VirginiaSB7452026 Regular SessionSenateWALLET

Health insurance; definitions, prohibited restrictions on in-network referrals.

Sponsored By: Kannan Srinivasan (Democratic)

Became Law

Summary

Health insurance; prohibited restrictions on in-network referrals. Prohibits a health insurance carrier from prohibiting an in-network provider, as defined in the bill, from referring any enrollee or specimen to any in-network clinical laboratory or in-network pathology service provider under the terms of such insurance unless such referral would constitute a violation of certain laws. This bill is identical to HB 424.

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 0 benefits, 1 costs, 3 mixed.

Rules for Medicaid and CHIP HMOs

If you get Medicaid or CHIP through the Department of Medical Assistance Services, the HMO plans for those programs follow this chapter and a short listed set of insurance rules. Other insurance rules in Title 38.2 do not apply to those HMOs. This clarifies which rules govern plan features and complaints for Medicaid and CHIP plans.

How Virginia HMOs are regulated

HMOs are mainly governed by this chapter and a few listed insurance sections; most other insurance laws do not apply to them. When a listed section says “insurer,” it also includes HMOs unless the section already names them. HMOs may market and solicit enrollees without that being treated as illegal professional solicitation. An HMO is not considered to be practicing medicine; doctors and other providers tied to an HMO still must follow all provider laws.

HMOs can deny out-of-area employees

An employer’s HMO plan does not have to enroll you if you live outside the HMO’s service area. Check your home address against the plan’s service area before you choose that option.

In-network lab referrals protected, new dispute path

The law bars health insurers from stopping an in-network doctor from sending you or your specimen to any in-network lab or pathology provider your plan covers. This applies to individual, group, and state employee health plans. Referrals are still not allowed if they would break Virginia’s Practitioner Self-Referral Act or the federal anti-kickback law (42 U.S.C. 1320a-7b). The State Corporation Commission does not hear individual disputes under this rule. You cannot bring these disputes to the Commission under this law.

Sponsors & Cosponsors

Sponsor

  • Kannan Srinivasan

    Democratic • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 268 • No: 0

House vote 2/24/2026

Passed House Block Vote

Yes: 98 • No: 0

House vote 2/19/2026

Reported from Labor and Commerce

Yes: 20 • No: 0

Senate vote 2/10/2026

Commerce and Labor Substitute agreed to

Yes: 0 • No: 0

Senate vote 2/10/2026

Constitutional reading dispensed Block Vote (on 3rd reading)

Yes: 40 • No: 0

Senate vote 2/10/2026

Read third time and passed Senate Block Vote

Yes: 40 • No: 0

Senate vote 2/9/2026

Constitutional reading dispensed Block Vote (on 1st reading)

Yes: 40 • No: 0

Senate vote 2/9/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 2/5/2026

Reported from Finance and Appropriations

Yes: 15 • No: 0

Senate vote 1/26/2026

Reported from Commerce and Labor with substitute and rereferred to Finance and Appropriations

Yes: 15 • No: 0

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0139)

    4/6/2026Governor
  2. Approved by Governor-Chapter 139 (effective 7/1/2026)

    4/6/2026Governor
  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

    3/10/2026Senate
  5. Fiscal Impact Statement from State Corporation Commission (SB745)

    3/3/2026Senate
  6. Bill text as passed Senate and House (SB745ER)

    2/26/2026Senate
  7. Enrolled

    2/26/2026Senate
  8. Signed by President

    2/26/2026Senate
  9. Signed by Speaker

    2/26/2026House
  10. Passed House Block Vote (98-Y 0-N 0-A)

    2/24/2026House
  11. Read third time

    2/24/2026House
  12. Read second time

    2/23/2026House
  13. Reported from Labor and Commerce (20-Y 0-N)

    2/19/2026House
  14. Read first time

    2/13/2026House
  15. Referred to Committee on Labor and Commerce

    2/13/2026House
  16. Placed on Calendar

    2/13/2026House
  17. Read third time and passed Senate Block Vote (40-Y 0-N 0-A)

    2/10/2026Senate
  18. Constitutional reading dispensed Block Vote (on 3rd reading) (40-Y 0-N 0-A)

    2/10/2026Senate
  19. Commerce and Labor Substitute agreed to

    2/10/2026Senate
  20. Rules suspended

    2/10/2026Senate
  21. Engrossed by Senate - committee substitute (Voice Vote)

    2/10/2026Senate
  22. Read second time

    2/10/2026Senate
  23. Passed by for the day Block Vote (Voice Vote)

    2/9/2026Senate
  24. Constitutional reading dispensed Block Vote (on 1st reading) (40-Y 0-N 0-A)

    2/9/2026Senate
  25. Passed by for the day

    2/9/2026Senate

Bill Text

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