Bill
Bill > HB1526
summary
Introduced
01/27/2026
01/27/2026
In Committee
01/27/2026
01/27/2026
Crossed Over
Passed
Dead
Introduced Session
2026 Regular Regular Session
Bill Summary
Health insurance; prior authorization; required contract provisions; work group. Requires any provider contract between a carrier and a participating health care provider or its contracting agent to contain specific provisions that (i) require a carrier to establish and maintain a prior authorization application program interface for processing prior authorization requests and (ii) require a participating health care provider to ensure that any electronic health record or health information technology system owned by or contracted for the provider to maintain the health record of an enrollee has the ability to access such application program interface. The bill amends requirements for the existing work group on electronic prior authorization.
AI Summary
This bill mandates that health insurance contracts between carriers (insurance companies) and healthcare providers must include provisions requiring carriers to establish and maintain an electronic system, known as an application program interface (API), for processing prior authorization requests, which is the process where an insurer approves certain medical services before they are provided. Additionally, healthcare providers must ensure their electronic health record systems can access this API. The bill also updates requirements for a work group that examines electronic prior authorization, expanding its scope to include monitoring the implementation of this new API, considering prospective prior authorization for prescription drugs, and evaluating whether to expand reporting metrics to include prescription drugs, all while aiming to align with federal standards and timelines.
Committee Categories
Business and Industry
Sponsors (1)
Last Action
Left in Labor and Commerce (on 02/18/2026)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://lis.virginia.gov/bill-details/20261/HB1526 |
| BillText | https://lis.virginia.gov/bill-details/20261/HB1526/text/HB1526 |
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