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VA HB328

VA HB328
Health insurance; essential health benefits benchmark plan selection.


summary

Introduced
01/11/2026
In Committee
03/09/2026
Crossed Over
03/12/2026
Passed
04/22/2026
Dead
Signed/Enacted/Adopted
04/22/2026

Introduced Session

Potential new amendment
2026 Regular Regular Session

Bill Summary

Health insurance; essential health benefits benchmark plan. Requires the Bureau of Insurance to select a new essential health benefits benchmark plan for the 2028 plan year, or the soonest plan year thereafter as permitted by the Centers for Medicare and Medicaid Services, that includes, in addition to the essential health benefits package included in the existing benchmark plan, coverage for (i) doula care services; (ii) the treatment of iatrogenic infertility; (iii) fertility treatment and diagnosis, including a maximum of three cycles per lifetime of assisted reproductive technology; (iv) hearing aids for individuals of all ages; (v) pasteurized donor human breast milk; (vi) the prophylaxis, diagnosis, and treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome; and (vii) the treatment of polycystic ovary syndrome. Such mandate for coverage does not apply to the individual or small group markets. Certain provisions of the bill have a delayed effective date pursuant to approval by the Centers for Medicare and Medicaid Services of certain coverage as outlined in the bill, and the bill contains an emergency clause applicable to certain other provisions. As introduced, this bill was a recommendation of the Health Insurance Reform Commission.

AI Summary

This bill requires the Bureau of Insurance to select a new essential health benefits benchmark plan for the Commonwealth, starting with the 2028 plan year or the earliest possible year thereafter, which must include coverage for doula care services, treatment of iatrogenic infertility and other fertility treatments (including up to three cycles of assisted reproductive technology), hearing aids for all ages, pasteurized donor human breast milk, treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS), and treatment for polycystic ovary syndrome (PCOS). The bill also amends existing laws to mandate coverage for hearing aids for children under 19 and for PANDAS and PANS, with specific conditions and limitations outlined for these treatments. Importantly, the mandate for coverage of these newly added benefits does not apply to the individual or small group health insurance markets, and the bill's effective date is contingent on approval by the Centers for Medicare and Medicaid Services (CMS) for certain coverage provisions.

Committee Categories

Budget and Finance, Business and Industry

Sponsors (19)

Last Action

Acts of Assembly Chapter text (CHAP1048) (on 04/22/2026)

Taxonomy

Health
  • ‐ Health Insurance Reform
  • ‐ Maternal Health
  • ‐ Treatment of Specific Diseases

bill text


bill summary

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bill summary

Document Type Source Location Created
State Bill Page https://lis.virginia.gov/bill-details/20261/HB328 01/12/2026
BillText https://lis.virginia.gov/bill-details/20261/HB328/text/CHAP1048 04/30/2026
BillText https://lis.virginia.gov/bill-details/20261/HB328/text/HB328ER2 04/23/2026
Governor's Recommendation HB328 https://lis.virginia.gov/bill-details/20261/HB328/text/HB328G 04/13/2026
BillText https://lis.virginia.gov/bill-details/20261/HB328/text/HB328ER 03/30/2026
Fiscal Note/Analysis - Fiscal Impact Statement from State Corporation Commission (HB328) https://lis.blob.core.windows.net/files/1197570.PDF 03/05/2026
BillText https://lis.virginia.gov/bill-details/20261/HB328/text/HB328S1 03/03/2026
BillText https://lis.virginia.gov/bill-details/20261/HB328/text/HB328SC1 03/02/2026
BillText https://lis.virginia.gov/bill-details/20261/HB328/text/HB328E 02/16/2026
Fiscal Note/Analysis - Fiscal Impact Statement from State Corporation Commission (HB328) https://lis.blob.core.windows.net/files/1127922.PDF 02/04/2026
Labor and Commerce Amendment https://lis.virginia.gov/bill-details/20261/HB328/text/HB328AH1 01/29/2026
Subcommittee #1 Subcommittee Amendment https://lis.virginia.gov/bill-details/20261/HB328/text/HB328AHC2 01/28/2026
BillText https://lis.virginia.gov/bill-details/20261/HB328/text/HB328HC1 01/27/2026
Labor and Commerce Amendment https://lis.virginia.gov/bill-details/20261/HB328/text/HB328AHC1 01/27/2026
BillText https://lis.virginia.gov/bill-details/20261/HB328/text/HB328 01/12/2026
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