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HOUSE BILL NO. 1462
AMENDMENT IN THE NATURE OF A SUBSTITUTE
(Proposed by the House Committee on Labor and Commerce
on February 12, 2026)
(Patron Prior to Substitute--Delegate Maldonado)
A BILL to amend the Code of Virginia by adding sections numbered
32.1-325.002
and
38.2-3408.1
, relating to supervised billing under Medicaid and health insurance plans.
Be it enacted by the General Assembly of Virginia:
1. That the Code of Virginia is amended by adding sections numbered
32.1-325.002
and
38.2-3408.1
as follows:
§
32.1-325.002
.
Medic
aid payments for
supervised billing.
A. For the purposes of this section:
"Qualified licensed provider" means a health care provider who is
licensed, enrolled in the Commonwealth's Medicaid program through the Department, and acting within his scope of practice.
A qualified licensed provider sh
all be licensed as a:
1. Physician of medicine or osteopathy
who is certified in psychiatry
by the American Board of Medical Specialties;
2. Advanced pract
ice registered nurse who is certified as a psychiatric mental health
nurse
practitioner;
3. Psychologist;
4. Marriage and family therapist;
5.
Professional counselor;
6. Clinical social worker;
7.
Behavior analyst; or
8. Licensed substance abuse treatment practitioner.
"Q
ualified non-licensed provider" means a provider
who
is actively working toward licensure pursuant to
the
requirements of the
healt
h regulatory
board of
his
profession
or
is otherwise permitted to provide se
rvices
pursuant to a licensure exception
if such provision constitutes a part of his course of study and is adequately supervised
, including services provided as part of an internship, apprenticeship, practicum, residency, or supervised clinical training program
.
"Supervised billing" means
billing by a qualified licensed provider for covered
mental health and substance abuse
services within his scope of practice provided by a qualified non-licensed provider when such qualified non-licensed provider is under the direct supervision of the qualified licensed provider.
B. The Department shall, conditional on the receipt of all necessary approvals and the securing of federal financial participation pursuant to subsection
D
,
permit a qualified licensed provider
to bill for
covered mental health and substance abuse
services provided by a qualified non-licensed provider as supervised billing.
C
.
A qualified licensed provider
engaging
in supervised billing pursuant to subsection B shall
a
dhere to the supervision requirements provided by his scope of practice
and
the relevant health regulatory board
.
D
. The Department shall submit any state plan amendments or waiver applications as may be necessary to implement the provisions of this section and to secure federal financial participation for state Medicaid expenditures under the federal Medicaid program.
Supervised billing
pursuant to this section shall be contingent on securing all necessary federal approvals and federal financial participation as may be necessary to implement the provisions of this section.
§
38.2-3408
.
1. Supervised billing.
A. As used in this section:
"Carrier" has the same meaning as provided in
§
38.2-3407.1
5
.
"Health plan" has the same meaning as provided in §
38.2-3407.15
.
"Mental health services" has the same meaning as provided
in §
38.2-3412.1
.
"Qualified licensed provider" means a health care provider who is licensed
and acting within his scope of practice. A qualified licensed provider shall be licensed as a:
1. Physician of medicine or osteopathy who is certified in psychiatry by the American Board of Medical Specialties;
2. Advanced practice registered nurse who is certified as a psychiatric mental health
nurse
practitioner;
3. Psychologist;
4. Marriage and family therapist;
5. Professional counselor;
6. Clinical social worker;
7. Behavior analyst; or
8. Licensed substance abuse treatment practitioner.
"Qualified non-licensed provider" means a provider
who
is actively working toward licensure pursuant to the requirements of the health regulatory board of his profession and is otherwise permitted to provide services pursuant to a licensure exception if such provision constitutes a part of his course of study and is adequately supervised.
"Substance abuse services" has the same meaning as provided in in §
38.2-3412.1
.
B.
Each carrier provid
ing a health plan shall provide c
overage
for
mental health
serv
ices
or substance
ab
use services provided
by a qualified non-licensed provider
under the supervision of a
qualified
licensed provider
when such services would be covered if provided by
a
qualified licensed provider
.
A
carrier
shall accept and reimburse claims submitted for
covered
mental health
services
or substance
ab
use services performed by a qualified non-licensed provider when such claims are submitted by the supervising qualified licensed provider
, who is the supervisor of
record with the requisite board
, as the rendering provider, using such provider's national provider identifier. A modifier shall be used to specify the qualified non-licensed provider degree level.
C. This section shall not apply to policies or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under federal governmental plans.
2. That if the Department of Medical Assistance Services does not receive the necessary approval or federal financial participation from the Centers for Medicare and Medicaid Services to implement the provisions of §
32.1-325.002
of the Code of Virginia, as created by this act, then the provisions of §
32.1-325.002
of the Code of Virginia, as created by this act, shall expire on July 1, 2027.
3. That the provisions of this act shall apply to any health plan as defined in §
38.2-3407.15
of the Code of Virginia delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2027.