Managed care organizations & pharmacy benefits manager; data collection and reporting requirements.
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HB1109 — Managed care organizations & pharmacy benefits manager; data collection and reporting requirements.
Last action — Left in Committee Appropriations
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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2In Committee
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3Passed House of Delegates
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4Passed Senate
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5To Executive
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6Enacted
This bill is in committee in the House of Delegates. Introduced January 14, 2026. It must pass committee before a floor vote.
Next likely step: a committee vote, then a floor vote in the House of Delegates.
Prognosis
Where this bill stands today.
Odds of enactment
LowHow often bills like it became law.
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In Committee
Current position in the legislative process.
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1 sponsor
1 primary, 0 co-sponsors signed on.
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Cleared a recorded vote
Passed 2 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
Managed care organizations & pharmacy benefits manager; data collection and reporting requirements.
Bill Text
We don't have the full text on file for this bill yet.
Read HB1109 on the official Virginia source →Compared against the Code of Virginia as published AI-generated reading aid — verify against the official bill.
This bill amends 1 section(s) of the Code of Virginia: 32.1-331.07..
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32.1-331.07.
A.
Inserts “A.”.
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32.1-331.07.
Managed
Inserts “Managed”.
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32.1-331.07.
care organizations and pharmacy benefits managers shall utilize standardized methodologies for collecting and reporting data to the
Inserts “care organizations and pharmacy benefits managers shall utilize standardized methodologies for collecting and reporting data to the”.
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32.1-331.07.
Department of Medical Assistance Servic
Inserts “Department of Medical Assistance Servic”.
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32.1-331.07.
es and
Inserts “es and”.
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32.1-331.07.
Centers for Medicare and Medicaid Services
Inserts “Centers for Medicare and Medicaid Services”.
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32.1-331.07.
. Such d
Inserts “. Such d”.
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32.1-331.07.
ata shall include a detailed breakdown of expenditures, rebates, and the source of all cost components.
Inserts “ata shall include a detailed breakdown of expenditures, rebates, and the source of all cost components.”.
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32.1-331.07.
The Department of Medical Assistance Services shall establish
Inserts “The Department of Medical Assistance Services shall establish”.
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32.1-331.07.
such standardized methodologies for collecting and reporting data by regulation, which shall include
Inserts “such standardized methodologies for collecting and reporting data by regulation, which shall include”.
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32.1-331.07.
reporting
Inserts “reporting”.
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32.1-331.07.
specific metrics related to drug spending, utilization rates, and prescription volumes
Inserts “specific metrics related to drug spending, utilization rates, and prescription volumes”.
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32.1-331.07.
in a timely manner.
Inserts “in a timely manner.”.
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32.1-331.07.
B. All transactions related to drug pricing, rebates negotiated by pharmacy benefits managers, and reimbursements
Inserts “B. All transactions related to drug pricing, rebates negotiated by pharmacy benefits managers, and reimbursements”.
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32.1-331.07.
shall
Inserts “shall”.
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32.1-331.07.
be
Inserts “be”.
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32.1-331.07.
included in the reporting required pursuant to subsection A and shall be
Inserts “included in the reporting required pursuant to subsection A and shall be”.
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32.1-331.07.
disclosed publicly
Inserts “disclosed publicly”.
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32.1-331.07.
to ensure
Inserts “to ensure”.
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32.1-331.07.
transparency in cost-sharing arrangements between pharmacy benefits managers, managed care o
Inserts “transparency in cost-sharing arrangements between pharmacy benefits managers, managed care o”.
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32.1-331.07.
rganizations, and pharmacies.
Inserts “rganizations, and pharmacies.”.
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32.1-331.07.
C. Managed care organizations shall solicit and undergo an independent audit of their data reporting practices every two
Inserts “C. Managed care organizations shall solicit and undergo an independent audit of their data reporting practices every two”.
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32.1-331.07.
years
Inserts “years”.
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32.1-331.07.
. Such audit shall evaluate compliance with this section and the accuracy of reported costs related to drug pricing and reimbursements.
Inserts “. Such audit shall evaluate compliance with this section and the accuracy of reported costs related to drug pricing and reimbursements.”.
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32.1-331.07.
Managed care organizations shall report the results of the audit to the Department of Medical Assistance Services and the Centers for Medicare and Medicaid Services. The Department of Medical Assistance Services may implement corrective actions for any managed care or
Inserts “Managed care organizations shall report the results of the audit to the Department of Medical Assistance Services and the Centers for Medicare and Medicaid Services. The Department of Medical Assistance Services may implement corrective actions for any managed care or”.
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32.1-331.07.
ganization whose independent audit pursuant to this section reveals any instances of significant discrepancies or inaccuracies of reported costs related to drug pricing and reimbursements.
Inserts “ganization whose independent audit pursuant to this section reveals any instances of significant discrepancies or inaccuracies of reported costs related to drug pricing and reimbursements.”.
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32.1-331.07.
D.
Inserts “D.”.
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32.1-331.07.
The Department of Medical Assistance Services shall establish a compliance unit responsible for overseeing the accuracy of data reported pursuant to this section and ensure that all entities
Inserts “The Department of Medical Assistance Services shall establish a compliance unit responsible for overseeing the accuracy of data reported pursuant to this section and ensure that all entities”.
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32.1-331.07.
required to submit data pursuant to this section comply with the provisions of this section.
Inserts “required to submit data pursuant to this section comply with the provisions of this section.”.
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32.1-331.07.
1.
Inserts “1.”.
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32.1-331.07.
Such compliance unit shall provide training and guidance to managed care organizations and pharmacy benefit
Inserts “Such compliance unit shall provide training and guidance to managed care organizations and pharmacy benefit”.
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32.1-331.07.
s managers on compliance with the provisions of this section and improving their data reporting capabilities.
Inserts “s managers on compliance with the provisions of this section and improving their data reporting capabilities.”.
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32.1-331.07.
2.
Inserts “2.”.
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32.1-331.07.
Such compliance unit may impose penalties on any managed care organization or pharmacy benefits manager
Inserts “Such compliance unit may impose penalties on any managed care organization or pharmacy benefits manager”.
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32.1-331.07.
, including:
Inserts “, including:”.
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32.1-331.07.
a. Civil penalties proportional to the degree of inaccurate reporting. Such civil penalty shall not exceed $10,000, shall be collected by the compliance unit established pursuant to thi
Inserts “a. Civil penalties proportional to the degree of inaccurate reporting. Such civil penalty shall not exceed $10,000, shall be collected by the compliance unit established pursuant to thi”.
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32.1-331.07.
s subsection, and shall be deposited into the general fund
Inserts “s subsection, and shall be deposited into the general fund”.
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32.1-331.07.
;
Inserts “;”.
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32.1-331.07.
b. Suspension of participation by the managed care organization or pharmacy benefits manager in administration of medical assistance services until
Inserts “b. Suspension of participation by the managed care organization or pharmacy benefits manager in administration of medical assistance services until”.
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32.1-331.07.
such managed care organization or pharmacy benefits manager achieves adequate compliance with the reporting requirements of this section; and
Inserts “such managed care organization or pharmacy benefits manager achieves adequate compliance with the reporting requirements of this section; and”.
Action History
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H Left in Committee Appropriations
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H Subcommittee recommends laying on the table (5-Y 2-N)
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H Placed on Appropriations Agenda
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H Assigned HAPP sub: Health & Human Resources
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H Referred to Committee on Appropriations
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H Reported from Health and Human Services and referred to Appropriations (22-Y 0-N)
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H Fiscal Impact Statement from Department of Planning and Budget (HB1109)
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H Placed on Health and Human Services Agenda
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H Placed on Health and Human Services Agenda
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H Placed on Health and Human Services Agenda
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H Assigned sub: Social Services
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H Referred to Committee on Health and Human Services
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H Prefiled and ordered printed; Offered 01-14-2026 26103692D
Sponsors
- M. Keith Hodges · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 147 not signed on · 1 voted No
Sponsors (1)
- M. Keith Hodges Voted No
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.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 5 | 2 | 0 | 1 |
| Total | 5 | 2 | 0 | 1 |
| % of votes cast | 63% | 25% | 0% | 13% |
How each member voted (8)
| Member | Party | Vote |
|---|---|---|
| Betsy B. Carr | — | Yea |
| C.E. Cliff Hayes, Jr. | — | Yea |
| Ellen H. McLaughlin | — | Nay |
| Kathy K.L. Tran | — | Yea |
| Luke E. Torian | — | Not Voting |
| M. Keith Hodges | — | Nay |
| Paul E. Krizek | — | Yea |
| Rodney T. Willett | — | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 22 | 0 | 0 | 0 |
| Total | 22 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (22)
| Member | Party | Vote |
|---|---|---|
| C.E. Cliff Hayes, Jr. | — | Yea |
| Charniele L. Herring | — | Yea |
| Debra D. Gardner | — | Yea |
| Garrett McGuire | — | Yea |
| H. Otto Wachsmann, Jr. | — | Yea |
| Irene Shin | — | Yea |
| Joshua G. Cole | — | Yea |
| Kathy K.L. Tran | — | Yea |
| Laura Jane Cohen | — | Yea |
| M. Keith Hodges | — | Yea |
| Marcia S. "Cia" Price | — | Yea |
| Mark C. Downey | — | Yea |
| Mike A. Cherry | — | Yea |
| Mitchell Cornett | — | Yea |
| Nicole Cole | — | Yea |
| Patrick A. Hope | — | Yea |
| Phillip A. Scott | — | Yea |
| Rodney T. Willett | — | Yea |
| Rozia A. Henson, Jr. | — | Yea |
| Sam Rasoul | — | Yea |
| Wendell S. Walker | — | Yea |
| Wren M. Williams | — | Yea |
Subjects
Frequently asked questions
- What does HB1109 do?
- Managed care organizations & pharmacy benefits manager; data collection and reporting requirements.
- Who sponsors HB1109?
- HB1109 is sponsored by M. Keith Hodges.
- What is the current status of HB1109?
- This bill is in committee in the House of Delegates. Introduced January 14, 2026. It must pass committee before a floor vote.
- Where can I track HB1109?
- Track HB1109 free on One Click Politics — get push/email alerts when it moves.
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Last checked for changes 4 months ago · updated continuously
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