Bill
Bill > HB736
VA HB736
VA HB736Health insurance; required provisions regarding prior authorization for prescription drugs.
summary
Introduced
01/13/2026
01/13/2026
In Committee
02/18/2026
02/18/2026
Crossed Over
02/16/2026
02/16/2026
Passed
Dead
Introduced Session
Potential new amendment
2026 Regular Regular Session
Bill Summary
Health insurance; carrier contracts; required provisions regarding prior authorization for prescription drugs. Amends existing required provisions for health carrier contracts related to prior authorizations for prescription drugs. Current law requires that if prior authorization is approved for prescription drugs and such prescription drugs have been scheduled, provided, or delivered to the patient consistent with the authorization, health carriers may not revoke, limit, condition, modify, or restrict that authorization except in certain circumstances. The bill requires this limitation on carriers to apply for the duration of the authorization, which the bill requires to be a minimum of six months for initial authorizations and a minimum of 12 months for continued authorizations. The bill adds circumstances under which a prior authorization may be revoked, limited, conditioned, modified, or restricted by a carrier, including (i) a final action by the U.S. Food and Drug Administration, other regulatory agencies, or the manufacturer communicating a patient efficacy issue that would affect the authorization and (ii) when additional safety and efficacy monitoring is clinically appropriate or recommended by the U.S. Food and Drug Administration, other regulatory agencies, or the manufacturer.
AI Summary
This bill amends existing laws regarding health insurance, specifically focusing on prior authorization for prescription drugs, which is the process health carriers use to approve certain drug benefits before they are provided to a patient. The key change is that once a prior authorization is approved and the prescription drugs are dispensed to the patient, health carriers can no longer revoke, limit, condition, modify, or restrict that authorization for a minimum of six months for initial approvals and a minimum of 12 months for continued approvals, unless specific exceptions apply. These exceptions now include situations where there's a final action from the U.S. Food and Drug Administration (FDA) or other regulatory bodies, or the manufacturer, indicating a patient efficacy issue or recommending additional safety monitoring for the drug. The bill aims to provide greater stability and predictability for patients and providers regarding prescription drug coverage.
Committee Categories
Budget and Finance, Business and Industry
Sponsors (2)
Last Action
Referred to Committee on Commerce and Labor (on 02/18/2026)
Official Document
bill text
bill summary
Loading...
bill summary
Loading...
bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://lis.virginia.gov/bill-details/20261/HB736 |
| Fiscal Note/Analysis - Fiscal Impact Statement from Department of Planning and Budget (HB736) | https://lis.blob.core.windows.net/files/1156873.PDF |
| BillText | https://lis.virginia.gov/bill-details/20261/HB736/text/HB736E |
| Labor and Commerce Amendment | https://lis.virginia.gov/bill-details/20261/HB736/text/HB736AH1 |
| Subcommittee #1 Subcommittee Amendment | https://lis.virginia.gov/bill-details/20261/HB736/text/HB736AHC1 |
| BillText | https://lis.virginia.gov/bill-details/20261/HB736/text/HB736 |
Loading...