Bill > HB358

This bill expands the authority of the State Corporation Commission to issue regulations for Medicare supplement policies, which are insurance plans that help cover costs not covered by Original Medicare. Specifically, it allows the Commission to establish minimum standards not only for claims processing and marketing but also for risk adjustment mechanisms, which are systems used to balance the financial risk between different insurance plans, and for disclosing the methods insurers use when deciding whether to cover a service. Additionally, the bill mandates the Bureau of Insurance to create a work group composed of various stakeholders, including health plans, providers, consumer counseling organizations, and actual Medicare supplement policyholders, to review and recommend improvements related to these policies. This work group will examine issues such as claim processing, risk adjustment, eliminating waste and abuse, coverage decision methodologies, improving care, and the effectiveness of consumer protections, and must submit a report of its findings and recommendations by December 1, 2026.

Budget and Finance, Business and Industry

https://lis.virginia.gov/bill-details/20261/HB358