Virginia 2022 Regular Session Status: Enacted

HB 360 — Health insurance; carrier contracts, carrier provision of certain prescription drug information.

Last action — Approved by Governor-Chapter 284 (effective - see bill)

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed House of Delegates
  4. ✓
    Passed Senate
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced January 11, 2022. Enacted.

Signed by Governor Glenn Youngkin (Republican) on April 08, 2022.

Prognosis

Likely to advance 70% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

  • Cleared a recorded vote

    Passed 7 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Summary

Health insurance; carrier disclosure of certain information. Requires each health insurance carrier, beginning July 1, 2025, to establish and maintain an online process that (i) links directly to e-prescribing systems and electronic health record systems that utilize the National Council for Prescription Drug Programs SCRIPT standard; (ii) can accept electronic prior authorization requests from a provider; (iii) can approve electronic prior authorization requests for which no additional information is needed by the carrier to process the prior authorization request, no clinical review is required, and that meet the carrier's criteria for approval; and (iv) otherwise meets the requirements of the relevant Code of Virginia section. The bill prohibits a carrier from (a) imposing a charge or fee on a participating health care provider for accessing the required online process required or (b) accessing, absent provider consent, provider data via the online process other than for the enrollee. The bill requires participating health care providers, beginning July 1, 2025, to ensure that any e-prescribing system or electronic health record system owned by or contracted for the provider to maintain an enrollee's health record has the ability to access the electronic prior authorization process established by a carrier and real-time cost information data for a covered prescription drug made available by a carrier. The bill provides that a provider may request a waiver of compliance for undue hardship for a period not to exceed 12 months. The bill requires any carrier or its pharmacy benefits manager to provide real-time cost information data to enrollees and contracted providers for a covered prescription drug, including any cost-sharing requirement or prior authorization requirements, and to ensure that the data is accurate. The bill requires that such cost information data is available to the provider in a format that a provider can access and understand such as through the provider's e-prescribing system or electronic health record system for which the carrier or pharmacy benefits manager or its designated subcontractor has adopted that utilizes the National Council for Prescription Drug Programs SCRIPT standard from which the provider makes the request.The bill requires the State Corporation Commission's Bureau of Insurance (the Bureau) to, in coordination with the Secretary of Health and Human Resources, establish a work group to evaluate and make recommendations to modify the process for prior authorization for drug benefits in order to maximize efficiency and minimize delays that include a single standardized process and any recommendations for necessary statutory or regulatory changes. The bill requires the work group to include relevant stakeholders, including representatives from the Virginia Association of Health Plans, the Medical Society of Virginia, the National Council for Prescription Drug Programs, the Virginia Pharmacists Association, and the Virginia Hospital and Healthcare Association, and other parties with an interest in the underlying technology. The bill requires the work group to report its findings and recommendations to the Chairmen of the Senate Committee on Commerce and Labor and the House Committee on Commerce and Energy by November 1, 2022. The provisions of the bill other than the requirement for the Bureau to establish the work group will not become effective unless reenacted by the 2023 Session of the General Assembly. This bill is identical to SB 428.

Bill Text

What changed in the latest version

142 added · 134 removed

Plain-language change summary

The bill HB 360 has been updated to enhance the process of prior authorization for prescription drugs in Virginia. It clarifies definitions related to health insurance carriers and mandates that provider contracts include provisions for accepting prior authorization requests electronically, as well as requiring the carrier to respond to requests within 24 hours. This change is important because it aims to streamline the approval process, making it faster and more efficient for healthcare providers and their patients.

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SESSION ENROLLED VIRGINIA ACTS OF ASSEMBLY –– CHAPTER E An Act to amend and reenact § 38.2-3407.15:2 of the Code of Virginia and to amend the Code of N disclosure of certain information.red 38.2-3407.15:7, relating to health insurance;
VIRGINIA ACTS OF ASSEMBLY -- 2022 SESSION CHAPTER 284 An Act to amend and reenact § 38.2-3407.15:2 of the Code of Virginia and to amend the Code of Virginia by adding a section numbered 38.2-3407.15:7, relating to health insurance;
carrier R O [H 360] L Approved L Be it enacted by the General Assembly of Virginia:
carrier disclosure of certain information.
E 1.
[H 360] Approved April 8, 2022 Be it enacted by the General Assembly of Virginia:
That § 38.2-3407.15:2 of the Code of Virginia is amended and reenacted and that the Code of D Vir§ 38.2-3407.15:2.
1.
That § 38.2-3407.15:2 of the Code of Virginia is amended and reenacted and that the Code of Virginia is amended by adding a section numbered 38.2-3407.15:7 as follows:
§ 38.2-3407.15:2.
"Prior authorization" means the approval process used by a carrier before certain drug benefits may be provided.
be provided.thorization" means the approval process used by a carrier before certain drug benefits may "Provider contract" has the same meaning ascribed thereto in subsection A of § 38.2-3407.15.
"Provider contract" has the same meaning ascribed thereto in subsection A of § 38.2-3407.15.
"Supplementation" means a request communicated by the carrier to the prescriber or his designee, for additional information, limited to items specifically requested on the applicable prior authorization request, necessary to approve or deny a prior authorization request.
"Supplementation" means a request communicated by the carrier to the prescriber or his desigHee, for additional information, limited to items specifically requested on the applicable prior authori3ation reqB.
B.
R 1.
1.
Require that the carrier communicate to the prescriber or his designee within 24 hours, including weekend hours, of submission of an urgent prior authorization request to the carrier, if submitted requires supplementation;lternate method directed by the carrier, that the request is approved, denied, or 3.
Require that the carrier communicate to the prescriber or his designee within 24 hours, including weekend hours, of submission of an urgent prior authorization request to the carrier, if submitted telephonically or in an alternate method directed by the carrier, that the request is approved, denied, or requires supplementation;
3.
Require that if the prior authorization request is denied, the carrier shall communicate established by subdivision 3 or 4, as applicable, the reasons for the denial;gnee, within the timeframes 6.
Require that if the prior authorization request is denied, the carrier shall communicate electronically, telephonically, or by facsimile to the prescriber or his designee, within the timeframes established by subdivision 3 or 4, as applicable, the reasons for the denial;
6.
Require that a tracking system be used by the carrier for all prior authorization requests and that the identification information be provided electronically, telephonically, or by facsimile to the prescriber or 8.
Require that a tracking system be used by the carrier for all prior authorization requests and that the identification information be provided electronically, telephonically, or by facsimile to the prescriber or his designee, upon the carrier's response to the prior authorization request;
8.
Require a carrier to honor a prior authorization issued by the carrier for a drug regardless of the current health plan;on changes plans with the same carrier and the drug is a covered benefit with 11.
Require a carrier to honor a prior authorization issued by the carrier for a drug regardless of whether the covered person changes plans with the same carrier and the drug is a covered benefit with the current health plan;
Require a carrier, when requiring a prescriber to provide supplemental information that is in the of 3 covered individual's health record or electronic health record, to identify the specific information required;
11.
12.
Require a carrier, when requiring a prescriber to provide supplemental information that is in the covered individual's health record or electronic health record, to identify the specific information required;
of 3 12.
Require a participating health care provider, beginning July 1, 2025, to ensure that any e-prescribing system or electronic health record system owned by or contracted for the provider to maintain an enrollee's health record has the ability to access the electronic prior authorization process established by a carrier as required by subdivision 15 and the real time cost information data for a covered prescription drug made available by a carrier pursuant to § 38.2-3407.15:7.
Require a participating health care provider, beginning July 1, 2025, to ensure that any e-prescribing system or electronic health record system owned by or contracted for the provider to maintain an enrollee's health record has the ability to access the electronic prior authorization process established by a carrier as required by subdivision 15 and the real-time cost information data for a covered prescription drug made available by a carrier pursuant to § 38.2-3407.15:7.
(federal employees), or 10 U.S.C.
(federal employees), or U.S.C.
of 3 "Enrollee" has the same meaning as provided in § 38.2-3407.10.
"Enrollee" has the same meaning as provided in § 38.2-3407.10.
E "Provider" has the same meaning as provided in § 38.2-3407.10.
"Provider" has the same meaning as provided in § 38.2-3407.10.
Beginning July 1, 2025, any carrier or its pharmacy benefits manager shall provide real-time cost information data to enrollees and contracted providers for a covered prescription drug, includiRg any Such cost information data shall be available to the provider in a format that a provider can aOcess and.
Beginning July 1, 2025, any carrier or its pharmacy benefits manager shall provide real-time cost information data to enrollees and contracted providers for a covered prescription drug, including any of 3 cost-sharing requirement or prior authorization requirements, and shall ensure that the data is accurate.
understand such as through the provider's e-prescribing system or electronic health record system for which the carrier or pharmacy benefits manager or its designated subcontractor has adopted thatL utilizes the National Council for Prescription Drug Programs SCRIPT standard from which the proLider 2.
Such cost information data shall be available to the provider in a format that a provider can access and understand such as through the provider's e-prescribing system or electronic health record system for which the carrier or pharmacy benefits manager or its designated subcontractor has adopted that utilizes the National Council for Prescription Drug Programs SCRIPT standard from which the provider makes the request.
That the State Corporation Commission's Bureau of Insurance (the Bureau) shall, in E coordination with the Secretary of Health and Human Resources, establish a work group to evaluate and make recommendations to modify the process for prior authorization for drug D benefits in order to maximize efficiency and minimize delays.
2.
Such recommendations shall include a single standardized process as required by this act and any recommendations for necessary representatives from the Virginia Association of Health Plans, the Medical Society of Virginia, the National Council for Prescription Drug Programs, the Virginia Pharmacists Association, and the Virginia Hospital and Healthcare Association, and other parties with an interest in the underlying technology.
That the State Corporation Commission's Bureau of Insurance (the Bureau) shall, in coordination with the Secretary of Health and Human Resources, establish a work group to evaluate and make recommendations to modify the process for prior authorization for drug benefits in order to maximize efficiency and minimize delays.
The work group shall report its findings and recommendations to the Chairmen of theH Senate Committee on Commerce and Labor and the House Committee on Commerce and Energy 3 3.
Such recommendations shall include a single standardized process as required by this act and any recommendations for necessary statutory or regulatory changes.
That the provisions of the first enactment of this act shall not become effective unless reeEacted by the 2023 Session of the General Assembly.
The work group shall include relevant stakeholders, including representatives from the Virginia Association of Health Plans, the Medical Society of Virginia, the National Council for Prescription Drug Programs, the Virginia Pharmacists Association, and the Virginia Hospital and Healthcare Association, and other parties with an interest in the underlying technology.
The work group shall report its findings and recommendations to the Chairmen of the Senate Committee on Commerce and Labor and the House Committee on Commerce and Energy by November 1, 2022.
3.
That the provisions of the first enactment of this act shall not become effective unless reenacted by the 2023 Session of the General Assembly.
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Action History

  1. Approved by Governor-Chapter 284 (effective - see bill)

  2. Governor's Action Deadline 11:59 p.m., April 11, 2022

  3. Enrolled Bill communicated to Governor on March 11, 2022

  4. Signed by President

  5. Impact statement from DPB (HB360ER)

  6. Signed by Speaker

  7. Enrolled

  8. VOTE: Adoption (97-Y 0-N)

  9. Senate amendments agreed to by House (97-Y 0-N)

  10. Passed Senate with amendments (40-Y 0-N)

  11. Engrossed by Senate as amended

  12. Amendments by Senator Dunnavant agreed to

  13. Reading of amendments waived

  14. Read third time

  15. Constitutional reading dispensed (40-Y 0-N)

  16. Reported from Commerce and Labor (15-Y 0-N)

  17. Referred to Committee on Commerce and Labor

  18. Constitutional reading dispensed

  19. VOTE: Block Vote Passage (100-Y 0-N)

  20. Read third time and passed House BLOCK VOTE (100-Y 0-N)

  21. Engrossed by House - committee substitute HB360H1

  22. Committee substitute agreed to 22105757D-H1

  23. Read second time

  24. Read first time

  25. Impact statement from DPB (HB360H1)

  26. Committee substitute printed 22105757D-H1

  27. Reported from Health, Welfare and Institutions with substitute (22-Y 0-N)

  28. Subcommittee recommends reporting with substitute (6-Y 0-N)

  29. House subcommittee amendments and substitutes offered

  30. Impact statement from DPB (HB360)

  31. Assigned HWI sub: Subcommittee #3

  32. Referred to Committee on Health, Welfare and Institutions

  33. Prefiled and ordered printed; offered 01/12/22 22100701D

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 147 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (147)

147 members have not signed on to this bill.

Show all 147 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

VOTE: Adoption (97-Y 0-N)

Passed 96 Yea · 0 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 96003
Total 96003
% of votes cast 97%0%0%3%
How each member voted (99)
Member Party Vote
Greenhalgh, Karen S. — Yea
March, Marie E. — Yea
Adams, Dawn M. — Yea
Adams, Les R. — Yea
Alfonso H. Lopez — Yea
Angelia Williams Graves — Yea
Anne Ferrell Tata — Yea
Avoli, G. "John" — Yea
Batten, Amanda E. — Yea
Bell, Robert B. — Yea
Betsy B. Carr — Yea
Bill Wiley — Yea
Bourne, Jeffrey M. — Yea
Briana D. Sewell — Yea
Bulova, David L. — Yea
Byron, Kathy J. — Yea
C.E. Cliff Hayes, Jr. — Yea
Campbell, Jeffrey L. — Yea
Campbell, Ronnie R. — Yea
Charniele L. Herring — Yea
Chris S. Runion — Yea
Christopher T. Head — Yea
Convirs-Fowler, Kelly K. — Not Voting
Cordoza, A.C. — Yea
Coyner, Carrie E. — Yea
Dan I. Helmer — Yea
Danica A. Roem — Yea
David A. Reid — Yea
Davis, Glenn R. — Yea
Delores L. McQuinn — Yea
Don Scott — Yea
Edmunds, James E., II — Yea
Elizabeth B. Bennett-Parker — Yea
Emily M. Jordan — Yea
Fariss, C. Matthew — Yea
Filler-Corn, Eileen — Yea
Fowler, Hyland F."Buddy," Jr. — Yea
Freitas, Nicholas J. — Yea
Gooditis, Wendy W. — Yea
Guzman, Elizabeth R. — Yea
H. Otto Wachsmann, Jr. — Yea
Hudson, Sally L. — Yea
Irene Shin — Yea
Israel D. O'Quinn — Yea
Jackie H. Glass — Yea
James A. "Jay" Leftwich — Yea
James W. Morefield — Not Voting
Jason S. Ballard — Yea
Jeion A. Ward — Yea
Jenkins, Clinton L. — Yea
Jessica L. Anderson — Yea
Joseph P. McNamara — Yea
Karrie K. Delaney — Yea
Kathy K.L. Tran — Yea
Keam, Mark L. — Yea
Knight, Barry D. — Yea
Kory, Kaye — Yea
LaRock, Dave A. — Yea
Lamont Bagby — Yea
Luke E. Torian — Yea
M. Keith Hodges — Yea
Maldonado, Michelle Lopes — Yea
Marcia S. "Cia" Price — Yea
Marcus B. Simon — Yea
Marshall, Daniel W., III — Yea
McGuire, John J., III — Yea
Michael J. Webert — Yea
Mike A. Cherry — Yea
Mullin, Michael P. — Yea
Mundon King, Candi — Not Voting
Murphy, Kathleen — Yea
Nadarius E. Clark — Yea
Orrock, Robert D., Sr. — Yea
Patrick A. Hope — Yea
Paul E. Krizek — Yea
Phillip A. Scott — Yea
Plum, Kenneth R. — Yea
R. Lee Ware — Yea
Ransone, Margaret B. — Yea
Richard C. "Rip" Sullivan, Jr. — Yea
Robert S. Bloxom, Jr. — Yea
Robinson, Roxann L. — Yea
Rodney T. Willett — Yea
Sam Rasoul — Yea
Schuyler T. VanValkenburg — Yea
Scott A. Wyatt — Yea
Shelly A. Simonds — Yea
Sickles, Mark D. — Yea
Subramanyam, Suhas — Yea
Tara A. Durant — Yea
Taylor, Kim A. — Yea
Terry G. Kilgore — Yea
Terry L. Austin — Yea
Thomas C. Wright, Jr. — Yea
Tony O. Wilt — Yea
Vivian E. Watts — Yea
Wampler, William C., III — Yea
Wendell S. Walker — Yea
Wren M. Williams — Yea

Official roll call →

Passed Senate with amendments (40-Y 0-N)

Passed 40 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 40000
Total 40000
% of votes cast 100%0%0%0%
How each member voted (40)
Member Party Vote
McClellan, Jennifer L. — Yea
Morrissey, Joseph D. — Yea
Spruill, Lionell, Sr. — Yea
Barbara A. Favola — Yea
Barker, George L. — Yea
Bell, John J. — Yea
Bill DeSteph — Yea
Bryce E. Reeves — Yea
Chase, Amanda F. — Yea
Cosgrove, John A., Jr. — Yea
David R. Suetterlein — Yea
David W. Marsden — Yea
Dunnavant, Siobhan S. — Yea
Ebbin, Adam P. — Yea
Edwards, John S. — Yea
Hanger, Emmett W., Jr. — Yea
Hashmi, Ghazala F. — Yea
Howell, Janet D. — Yea
Jennifer B. Boysko — Yea
Jeremy S. McPike — Yea
Kiggans, Jennifer A. — Yea
L. Louise Lucas — Yea
Lewis, Lynwood W., Jr. — Yea
Mamie E. Locke — Yea
Mark D. Obenshain — Yea
Mark J. Peake — Yea
Mason, T. Montgomery "Monty" — Yea
Newman, Stephen D. — Yea
Norment, Thomas K., Jr. — Yea
Petersen, J. Chapman — Yea
R. Creigh Deeds — Yea
Richard H. Stuart — Yea
Ruff, Frank M., Jr. — Yea
Ryan T. McDougle — Yea
Saslaw, Richard L. — Yea
Scott A. Surovell — Yea
T. Travis Hackworth — Yea
Todd E. Pillion — Yea
Vogel, Jill Holtzman — Yea
William M. Stanley, Jr. — Yea

Official roll call →

Constitutional reading dispensed (40-Y 0-N)

Passed 40 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 40000
Total 40000
% of votes cast 100%0%0%0%
How each member voted (40)
Member Party Vote
McClellan, Jennifer L. — Yea
Morrissey, Joseph D. — Yea
Spruill, Lionell, Sr. — Yea
Barbara A. Favola — Yea
Barker, George L. — Yea
Bell, John J. — Yea
Bill DeSteph — Yea
Bryce E. Reeves — Yea
Chase, Amanda F. — Yea
Cosgrove, John A., Jr. — Yea
David R. Suetterlein — Yea
David W. Marsden — Yea
Dunnavant, Siobhan S. — Yea
Ebbin, Adam P. — Yea
Edwards, John S. — Yea
Hanger, Emmett W., Jr. — Yea
Hashmi, Ghazala F. — Yea
Howell, Janet D. — Yea
Jennifer B. Boysko — Yea
Jeremy S. McPike — Yea
Kiggans, Jennifer A. — Yea
L. Louise Lucas — Yea
Lewis, Lynwood W., Jr. — Yea
Mamie E. Locke — Yea
Mark D. Obenshain — Yea
Mark J. Peake — Yea
Mason, T. Montgomery "Monty" — Yea
Newman, Stephen D. — Yea
Norment, Thomas K., Jr. — Yea
Petersen, J. Chapman — Yea
R. Creigh Deeds — Yea
Richard H. Stuart — Yea
Ruff, Frank M., Jr. — Yea
Ryan T. McDougle — Yea
Saslaw, Richard L. — Yea
Scott A. Surovell — Yea
T. Travis Hackworth — Yea
Todd E. Pillion — Yea
Vogel, Jill Holtzman — Yea
William M. Stanley, Jr. — Yea

Official roll call →

Reported from Commerce and Labor (15-Y 0-N)

Passed 15 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 15000
Total 15000
% of votes cast 100%0%0%0%
How each member voted (15)
Member Party Vote
Spruill, Lionell, Sr. — Yea
Barker, George L. — Yea
Bell, John J. — Yea
David W. Marsden — Yea
Ebbin, Adam P. — Yea
Edwards, John S. — Yea
L. Louise Lucas — Yea
Lewis, Lynwood W., Jr. — Yea
Mark D. Obenshain — Yea
Mason, T. Montgomery "Monty" — Yea
Newman, Stephen D. — Yea
Norment, Thomas K., Jr. — Yea
R. Creigh Deeds — Yea
Saslaw, Richard L. — Yea
Scott A. Surovell — Yea

Official roll call →

VOTE: Block Vote Passage (100-Y 0-N)

Passed 99 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 99000
Total 99000
% of votes cast 100%0%0%0%
How each member voted (99)
Member Party Vote
Greenhalgh, Karen S. — Yea
March, Marie E. — Yea
Adams, Dawn M. — Yea
Adams, Les R. — Yea
Alfonso H. Lopez — Yea
Angelia Williams Graves — Yea
Anne Ferrell Tata — Yea
Avoli, G. "John" — Yea
Batten, Amanda E. — Yea
Bell, Robert B. — Yea
Betsy B. Carr — Yea
Bill Wiley — Yea
Bourne, Jeffrey M. — Yea
Briana D. Sewell — Yea
Bulova, David L. — Yea
Byron, Kathy J. — Yea
C.E. Cliff Hayes, Jr. — Yea
Campbell, Jeffrey L. — Yea
Campbell, Ronnie R. — Yea
Charniele L. Herring — Yea
Chris S. Runion — Yea
Christopher T. Head — Yea
Convirs-Fowler, Kelly K. — Yea
Cordoza, A.C. — Yea
Coyner, Carrie E. — Yea
Dan I. Helmer — Yea
Danica A. Roem — Yea
David A. Reid — Yea
Davis, Glenn R. — Yea
Delores L. McQuinn — Yea
Don Scott — Yea
Edmunds, James E., II — Yea
Elizabeth B. Bennett-Parker — Yea
Emily M. Jordan — Yea
Fariss, C. Matthew — Yea
Filler-Corn, Eileen — Yea
Fowler, Hyland F."Buddy," Jr. — Yea
Freitas, Nicholas J. — Yea
Gooditis, Wendy W. — Yea
Guzman, Elizabeth R. — Yea
H. Otto Wachsmann, Jr. — Yea
Hudson, Sally L. — Yea
Irene Shin — Yea
Israel D. O'Quinn — Yea
Jackie H. Glass — Yea
James A. "Jay" Leftwich — Yea
James W. Morefield — Yea
Jason S. Ballard — Yea
Jeion A. Ward — Yea
Jenkins, Clinton L. — Yea
Jessica L. Anderson — Yea
Joseph P. McNamara — Yea
Karrie K. Delaney — Yea
Kathy K.L. Tran — Yea
Keam, Mark L. — Yea
Knight, Barry D. — Yea
Kory, Kaye — Yea
LaRock, Dave A. — Yea
Lamont Bagby — Yea
Luke E. Torian — Yea
M. Keith Hodges — Yea
Maldonado, Michelle Lopes — Yea
Marcia S. "Cia" Price — Yea
Marcus B. Simon — Yea
Marshall, Daniel W., III — Yea
McGuire, John J., III — Yea
Michael J. Webert — Yea
Mike A. Cherry — Yea
Mullin, Michael P. — Yea
Mundon King, Candi — Yea
Murphy, Kathleen — Yea
Nadarius E. Clark — Yea
Orrock, Robert D., Sr. — Yea
Patrick A. Hope — Yea
Paul E. Krizek — Yea
Phillip A. Scott — Yea
Plum, Kenneth R. — Yea
R. Lee Ware — Yea
Ransone, Margaret B. — Yea
Richard C. "Rip" Sullivan, Jr. — Yea
Robert S. Bloxom, Jr. — Yea
Robinson, Roxann L. — Yea
Rodney T. Willett — Yea
Sam Rasoul — Yea
Schuyler T. VanValkenburg — Yea
Scott A. Wyatt — Yea
Shelly A. Simonds — Yea
Sickles, Mark D. — Yea
Subramanyam, Suhas — Yea
Tara A. Durant — Yea
Taylor, Kim A. — Yea
Terry G. Kilgore — Yea
Terry L. Austin — Yea
Thomas C. Wright, Jr. — Yea
Tony O. Wilt — Yea
Vivian E. Watts — Yea
Wampler, William C., III — Yea
Wendell S. Walker — Yea
Wren M. Williams — Yea

Official roll call →

Reported from Health, Welfare and Institutions with substitute (22-Y 0-N)

Passed 22 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 22000
Total 22000
% of votes cast 100%0%0%0%
How each member voted (22)
Member Party Vote
March, Marie E. — Yea
Adams, Dawn M. — Yea
Bell, Robert B. — Yea
C.E. Cliff Hayes, Jr. — Yea
Christopher T. Head — Yea
Edmunds, James E., II — Yea
Fariss, C. Matthew — Yea
Guzman, Elizabeth R. — Yea
H. Otto Wachsmann, Jr. — Yea
Hudson, Sally L. — Yea
Karrie K. Delaney — Yea
Kathy K.L. Tran — Yea
M. Keith Hodges — Yea
Marcia S. "Cia" Price — Yea
Mike A. Cherry — Yea
Orrock, Robert D., Sr. — Yea
Patrick A. Hope — Yea
Phillip A. Scott — Yea
Robinson, Roxann L. — Yea
Rodney T. Willett — Yea
Sickles, Mark D. — Yea
Wendell S. Walker — Yea

Official roll call →

Subjects

healthcare health-insurance technology
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Frequently asked questions

What does HB 360 do?
Health insurance; carrier disclosure of certain information. Requires each health insurance carrier, beginning July 1, 2025, to establish and maintain an online process that (i) links directly to e-prescribing systems and electronic health record systems that utilize the National Council for Prescription Drug Programs SCRIPT standard; (ii) can accept electronic prior authorization requests from a provider; (iii) can approve electronic prior authorization requests for which no additional information is needed by the carrier to process the prior authorization request, no clinical review is required, and that meet the carrier's criteria for approval; and (iv) otherwise meets the requirements of the relevant Code of Virginia section. The bill prohibits a carrier from (a) imposing a charge or fee on a participating health care provider for accessing the required online process required or (b) accessing, absent provider consent, provider data via the online process other than for the enrollee. The bill requires participating health care providers, beginning July 1, 2025, to ensure that any e-prescribing system or electronic health record system owned by or contracted for the provider to maintain an enrollee's health record has the ability to access the electronic prior authorization process established by a carrier and real-time cost information data for a covered prescription drug made available by a carrier. The bill provides that a provider may request a waiver of compliance for undue hardship for a period not to exceed 12 months. The bill requires any carrier or its pharmacy benefits manager to provide real-time cost information data to enrollees and contracted providers for a covered prescription drug, including any cost-sharing requirement or prior authorization requirements, and to ensure that the data is accurate. The bill requires that such cost information data is available to the provider in a format that a provider can access and understand such as through the provider's e-prescribing system or electronic health record system for which the carrier or pharmacy benefits manager or its designated subcontractor has adopted that utilizes the National Council for Prescription Drug Programs SCRIPT standard from which the provider makes the request.The bill requires the State Corporation Commission's Bureau of Insurance (the Bureau) to, in coordination with the Secretary of Health and Human Resources, establish a work group to evaluate and make recommendations to modify the process for prior authorization for drug benefits in order to maximize efficiency and minimize delays that include a single standardized process and any recommendations for necessary statutory or regulatory changes. The bill requires the work group to include relevant stakeholders, including representatives from the Virginia Association of Health Plans, the Medical Society of Virginia, the National Council for Prescription Drug Programs, the Virginia Pharmacists Association, and the Virginia Hospital and Healthcare Association, and other parties with an interest in the underlying technology. The bill requires the work group to report its findings and recommendations to the Chairmen of the Senate Committee on Commerce and Labor and the House Committee on Commerce and Energy by November 1, 2022. The provisions of the bill other than the requirement for the Bureau to establish the work group will not become effective unless reenacted by the 2023 Session of the General Assembly. This bill is identical to SB 428.
Who sponsors HB 360?
HB 360 is sponsored by Hyland F. "Buddy" Fowler, Jr..
What is the current status of HB 360?
This bill has been enacted into law. Introduced January 11, 2022. Enacted.
Where can I track HB 360?
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