Bill > SB745

This bill, titled "Health insurance; prohibited restrictions on in-network referrals," aims to prevent health insurance carriers from unfairly restricting providers within their network. Specifically, it prohibits a "carrier" (which includes entities that administer health insurance for state employees) from stopping an "in-network provider" (a healthcare professional or facility contracted with the carrier to provide services at a set rate) from referring patients or specimens to any other in-network clinical laboratory or pathology service provider. This prohibition applies to individual or group accident and sickness insurance, including any "health plan" (which also encompasses coverage for state employees), unless such a referral would violate specific laws like the Practitioner Self-Referral Act or federal anti-kickback statutes. The bill also clarifies that the Commission will not handle individual disputes arising from this new provision.

Budget and Finance, Business and Industry

https://lis.virginia.gov/bill-details/20261/SB745