VA SB 98

Title: Health insurance; if prior authorization request is approved for prescription drugs.
Author: Barbara A. Favola

Summary
Health insurance; prior authorization. Requires that any provider contract between a carrier and a participating health care provider contain specific provisions that require that if a prior authorization request is approved for prescription drugs and such prescription drugs have been scheduled, provided, or delivered to the patient consistent with the authorization, the carrier shall not revoke, limit, condition, modify, or restrict that authorization unless (i) there is evidence that the authorization was obtained based on fraud or misrepresentation; (ii) final actions by the U.S. Food and Drug Administration, other regulatory agencies, or the manufacturer remove the drug from the market, limit its use in a manner that affects the authorization, or communicate a patient safety issue that would affect the authorization alone or in combination with other authorizations; (iii) a combination of drugs prescribed would cause a drug interaction; or (iv) a generic or biosimilar is added to the prescription drug formulary. The bill provides that such provisions do not require a carrier to cover any benefit not otherwise covered or cover a prescription drug if the enrollee is no longer covered by a health plan on the date the prescription drug was scheduled, provided, or delivered. This bill is identical to HB 1134.

Status
Governor: Governor's Action Deadline 11:59 p.m., April 8, 2024

Bill Documents
VA SB 98 - Prefiled and ordered printed; offered 01/10/24 24101001D
2024-01-02 - VA SB 98 (Prefiled and ordered printed; offered 01/10/24 24101001D)

---

VA SB 98 - Senate committee, floor amendments and substitutes offered
2024-01-02 - VA SB 98 (Senate committee, floor amendments and substitutes offered)

---

VA SB 98 - Committee substitute printed 24105929D-S1
2024-01-02 - VA SB 98 (Committee substitute printed 24105929D-S1)

---

VA SB 98 - House committee amendments reported
2024-01-02 - VA SB 98 (House committee amendments reported)

---

VA SB 98 - House amendments engrossed
2024-01-02 - VA SB 98 (House amendments engrossed)

---

VA SB 98 - House amendments adopted
2024-01-02 - VA SB 98 (House amendments adopted)

---

VA SB 98 - Bill text as passed Senate and House (SB98ER)
2024-01-02 - VA SB 98 (Bill text as passed Senate and House (SB98ER))

---

Add To Favorites