Bill > HB795

This bill requires health insurance providers, including those offering health care subscription plans and health maintenance organizations, to cover at least one opioid antagonist used for overdose reversal, which are medications that can counteract the effects of an opioid overdose. This coverage must be available when prescribed by a doctor, either verbally, in writing, or through a standing order, and the lowest cost-sharing tier on the insurer's prescription drug list must include at least one of these life-saving medications. Importantly, insurers cannot require prior authorization (pre-approval) or step therapy (requiring patients to try other medications first) for these opioid antagonists, ensuring prompt access in emergencies. This legislation, which is identical to another bill (SB 257) and was recommended by the Joint Commission on Health Care, will apply to policies, contracts, and plans delivered, issued, or renewed in Virginia starting January 1, 2027, with an exception for certain government plans and short-term policies.

Budget and Finance, Business and Industry, Health and Social Services

https://lis.virginia.gov/bill-details/20261/HB795