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VA SB735

VA SB735
Health insurance; denial of referral by direct primary care provider prohibited.


summary

Introduced
01/19/2024
In Committee
01/19/2024
Crossed Over
Passed
Dead
04/11/2024

Introduced Session

2024 Regular Session

Bill Summary

Health insurance; denial of referral by direct primary care provider prohibited. Prohibits a health insurance carrier from (i) denying payment for any health care service covered under an enrollee's health benefit plan based solely on the basis that such enrollee's referral was made by a direct primary care provider or (ii) imposing a cost-sharing requirement greater than the applicable cost-sharing requirement that would apply to the same health care service if the service was referred by a participating provider. The bill provides that a health insurance carrier may require a direct primary care provider to provide information demonstrating that such provider has entered into a direct primary care agreement with the enrollee.

AI Summary

This bill prohibits health insurance carriers from denying payment for any covered health care service solely on the basis that the referral was made by a direct primary care provider, or from imposing a higher cost-sharing requirement for such services compared to those referred by a participating provider. The bill also allows carriers to require direct primary care providers to provide information demonstrating they have entered into a direct primary care agreement with the enrollee, which may include a written attestation or copy of the agreement.

Committee Categories

Business and Industry

Sponsors (1)

Last Action

Continued to 2025 in Commerce and Labor (9-Y 6-N) (on 02/05/2024)

bill text


bill summary

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bill summary

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bill summary

Document Type Source Location
State Bill Page https://lis.virginia.gov/cgi-bin/legp604.exe?241+sum+SB735
Fiscal Note/Analysis - Senate: Presented and ordered printed 241 https://lis.virginia.gov/cgi-bin/legp604.exe?241+oth+SB735F122+PDF
BillText https://lis.virginia.gov/cgi-bin/legp604.exe?241+ful+SB735+hil
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