HB795 • 2026

Health insurance; requirements for certain opioid antagonists.

An Act to amend the Code of Virginia by adding a section numbered 38.2-3407.18:1, relating to health insurance; requirements for certain opioid antagonists.

Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor: Reaser
Last action: 2026-04-08
Official status: Acts of Assembly Chapter
Effective date: Not listed

Plain English Breakdown

The official text does not specify the exact date of enactment or implementation beyond the effective date for policies starting January 1, 2027.

Health Insurance Requirements for Opioid Antagonists

This act requires health insurance policies that cover prescription drugs to include coverage for at least one opioid antagonist used for reversing drug overdoses, with no prior authorization or step therapy requirements.

What This Bill Does

Requires health insurers and organizations providing health care plans to cover at least one opioid antagonist used for overdose reversal.
Ensures that the cost-sharing for these drugs is on the lowest tier of the prescription drug formulary.
Exempts coverage from prior authorization or step therapy requirements, allowing quicker access to these medications.

Who It Names or Affects

Health insurers
Corporations providing health care subscription plans
Health maintenance organizations

Terms To Know

Opioid antagonist: A drug that can reverse the effects of an opioid overdose.
Prior authorization: A requirement by insurance companies to get approval before a treatment or medication is covered.

Limits and Unknowns

The act does not apply to short-term travel, accident-only policies, Medicare plans, and similar government programs.
It applies only to health insurance policies delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2027.

Bill History

2026-04-08 Governor
Approved by Governor-Chapter 423 (effective 7/1/2026)
2026-04-08 Governor
Acts of Assembly Chapter text (CHAP0423)
2026-04-01 House
Fiscal Impact Statement from Department of Planning and Budget (HB795)
2026-03-31 House
Enrolled Bill communicated to Governor on March 31, 2026
2026-03-31 Governor
Governor's Action Deadline 11:59 p.m., April 13, 2026
2026-03-31 House
Signed by Speaker
2026-03-31 House
Enrolled Bill communicated to Governor on March 31, 2026
2026-03-31 Governor
Governor's Action Deadline 11:59 p.m., April 13, 2026
2026-03-30 Senate
Signed by President
2026-03-30 House
Enrolled
2026-03-30 House
Bill text as passed House and Senate (HB795ER)
2026-03-12 House
Senate substitute agreed to by House (96-Y 0-N 0-A)
2026-03-11 Senate
Read third time
2026-03-11 Senate
Engrossed by Senate - committee substitute
2026-03-11 Senate
Passed Senate with substitute
2026-03-11 Commerce and Labor
Commerce and Labor Substitute agreed to
2026-03-11 Senate
Passed Senate with substitute Block Vote (39-Y 0-N 0-A)
2026-03-11 Senate
Reconsideration of Senate passage agreed to by Senate Block Vote (40-Y 0-N 0-A)
2026-03-11 Senate
Passed Senate with substitute Block Vote (40-Y 0-N 0-A)
2026-03-10 Senate
Rules suspended
2026-03-10 Senate
Passed by for the day
2026-03-10 Commerce and Labor
Fiscal Impact Statement from Department of Planning and Budget (HB795)
2026-03-10 Senate
Constitutional reading dispensed Block Vote (on 2nd reading) (37-Y 0-N 0-A)
2026-03-10 Senate
Passed by for the day Block Vote (Voice Vote)
2026-03-09 Commerce and Labor
Reported from Commerce and Labor with substitute and rereferred to Finance and Appropriations (15-Y 0-N)
2026-03-09 Finance and Appropriations
Reported from Finance and Appropriations (14-Y 0-N)
2026-03-09 Senate
Senate committee offered
2026-03-09 Commerce and Labor
Committee substitute printed 26109503D-S1
2026-02-16 Senate
Constitutional reading dispensed (on 1st reading)
2026-02-16 Commerce and Labor
Referred to Committee on Commerce and Labor
2026-02-13 House
Read third time and passed House Block Vote (96-Y 0-N 0-A)
2026-02-12 House
Read second time
2026-02-12 House
committee substitute agreed to
2026-02-12 House
Engrossed by House - committee substitute
2026-02-11 House
Read first time
2026-02-09 Appropriations
Reported from Appropriations (22-Y 0-N)
2026-02-09 Compensation and Retirement
Subcommittee recommends reporting (7-Y 0-N)
2026-02-06 Labor and Commerce
Fiscal Impact Statement from Department of Planning and Budget (HB795)
2026-02-05 Compensation and Retirement
Assigned HAPP sub: Compensation and Retirement
2026-02-05 Labor and Commerce
Reported from Labor and Commerce with substitute and referred to Appropriations (22-Y 0-N)
2026-02-05 Labor and Commerce
Committee substitute printed 26107033D-H1
2026-02-03 Subcommittee #1
Subcommittee recommends reporting with substitute (9-Y 0-N)
2026-02-03 Subcommittee #1
House subcommittee offered
2026-01-28 Subcommittee #1
Assigned HCL sub: Subcommittee #1
2026-01-27 Health and Human Services
Referred from Health and Human Services and referred to Labor and Commerce (Voice Vote)
2026-01-23 House
Fiscal Impact Statement from Department of Planning and Budget (HB795)
2026-01-13 House
Prefiled and ordered printed; Offered 01-14-2026 26104745D
2026-01-13 Health and Human Services
Referred to Committee on Health and Human Services

Official Summary Text

Health insurance; requirements for certain opioid antagonists.
Requires each health insurer, corporation providing health care subscription plans, and health maintenance organization whose policy, contract, or plan includes coverage for prescription drugs to include coverage for at least one other opioid antagonist used for overdose reversal dispensed pursuant to an oral, written, or standing order of a prescriber and ensure that cost-sharing for at least one opioid antagonist used for overdose reversal is included on the lowest cost tier of the insurer's, corporation's, or health maintenance organization's prescription drug formulary. The bill provides that such coverage shall be exempt from any prior authorization or step therapy requirement on coverage of benefits. As introduced, this bill was a recommendation of the Joint Commission on Health Care. This bill is identical to SB 257.

Current Bill Text

Read the full stored bill text

An Act to amend the Code of Virginia by adding a section numbered
38.2-3407.18:1
, relating to health insurance; requirements for certain opioid antagonists.
Be it enacted by the General Assembly of Virginia:
1. That the Code of Virginia is amended by adding a section numbered
38.2-3407.18:1
as follows:
§
38.2-3407.18:1
. Requirements for certain opioid antagonists.
A. Notwithstanding the provisions of §
38.2-3419
, subdivision A 1 of §
38.2-6506
, or any other provision of law, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical, and surgical or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services whose policy, contract, or plan, including any certificate or evidence of coverage issued in connection with such policy, contract, or plan, shall include coverage for at least one opioid antagonist used for overdose reversal dispensed pursuant to an oral, written, or standing order of a prescriber and shall ensure that cost-sharing for at least one opioid antagonist used for overdose reversal is included on the lowest cost tier of the insurer's, corporation's, or health maintenance organization's prescription drug formulary.
B. No insurer, corporation, or health maintenance organization shall impose any prior authorization or step therapy requirement on coverage of benefits provided pursuant to this section.
C. The provisions of this section shall not apply to short-term travel, accident-only, limited or specified disease 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 state or federal governmental plans or to short-term nonrenewable policies of not more than six months' duration.
2. That the provisions of this act shall apply to any individual or group accident and sickness insurance policy, individual or group accident and sickness subscription contract, or health care plan for health care services delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2027.
3. That to the extent the health benefit or any portion thereof described in
38.2-3407.18:1
of the Code of Virginia, as created by this act, is included in the Commonwealth's current essential health benefits benchmark plan, as defined in §
30-343.1
of the Code of Virginia, the mandate to provide coverage of such health benefit or portion of the health benefit shall not apply to the individual and small group markets.