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SB745 • 2026

Health insurance; definitions, prohibited restrictions on in-network referrals.

An Act to amend and reenact § 38.2-4319 of the Code of Virginia and to amend the Code of Virginia by adding in Article 1 of Chapter 34 of Title 38.2 a section numbered 38.2-3407.23, relating to health insurance; prohibited restrictions on in-network referrals.

Healthcare Labor
Enacted

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

Sponsor
Srinivasan
Last action
2026-04-06
Official status
Acts of Assembly Chapter
Effective date
Not listed

Plain English Breakdown

The official source material does not provide details on enforcement mechanisms or consequences for violations, leaving these aspects unclear.

Health Insurance; Prohibited Restrictions on In-Network Referrals

This act stops insurance companies from preventing in-network doctors from sending patients or samples to other in-network labs or pathology services, unless it breaks certain laws.

What This Bill Does

  • Defines 'carrier' and 'health plan'.
  • Specifies that an 'in-network' provider is one who has a contract with the carrier to provide healthcare services at a set rate.
  • Prohibits carriers from stopping in-network providers from referring patients or samples to other in-network labs or pathology services, unless it violates specific laws.

Who It Names or Affects

  • Health insurance companies
  • In-network healthcare providers

Terms To Know

Carrier
An entity that provides health insurance coverage, including those administering policies for state employees.
In-Network Provider
A healthcare provider who has a contract with an insurance carrier to provide services at a set rate.

Limits and Unknowns

  • The bill does not specify the consequences if carriers violate these prohibitions.
  • It is unclear how this act will be enforced or monitored by regulatory bodies.

Bill History

  1. 2026-04-06 Governor

    Approved by Governor-Chapter 139 (effective 7/1/2026)

  2. 2026-04-06 Governor

    Approved by Governor-Chapter 139 (effective 7/1/2026)

  3. 2026-04-06 Governor

    Acts of Assembly Chapter text (CHAP0139)

  4. 2026-03-10 Senate

    Enrolled Bill communicated to Governor on March 10, 2026

  5. 2026-03-10 Governor

    Governor's Action Deadline 11:59 p.m., April 13, 2026

  6. 2026-03-03 Senate

    Fiscal Impact Statement from State Corporation Commission (SB745)

  7. 2026-02-26 House

    Signed by Speaker

  8. 2026-02-26 Senate

    Signed by President

  9. 2026-02-26 Senate

    Enrolled

  10. 2026-02-26 Senate

    Bill text as passed Senate and House (SB745ER)

  11. 2026-02-24 House

    Read third time

  12. 2026-02-24 House

    Passed House Block Vote (98-Y 0-N 0-A)

  13. 2026-02-23 House

    Read second time

  14. 2026-02-19 Labor and Commerce

    Reported from Labor and Commerce (20-Y 0-N)

  15. 2026-02-13 House

    Placed on Calendar

  16. 2026-02-13 Labor and Commerce

    Referred to Committee on Labor and Commerce

  17. 2026-02-13 House

    Read first time

  18. 2026-02-10 Senate

    Read second time

  19. 2026-02-10 Senate

    Engrossed by Senate - committee substitute (Voice Vote)

  20. 2026-02-10 Senate

    Rules suspended

  21. 2026-02-10 Commerce and Labor

    Commerce and Labor Substitute agreed to

  22. 2026-02-10 Senate

    Engrossed by Senate Block Vote (Voice Vote)

  23. 2026-02-10 Senate

    Constitutional reading dispensed Block Vote (on 3rd reading) (40-Y 0-N 0-A)

  24. 2026-02-10 Senate

    Read third time and passed Senate Block Vote (40-Y 0-N 0-A)

  25. 2026-02-09 Senate

    Rules suspended

  26. 2026-02-09 Senate

    Passed by for the day

  27. 2026-02-09 Senate

    Constitutional reading dispensed Block Vote (on 1st reading) (40-Y 0-N 0-A)

  28. 2026-02-09 Senate

    Passed by for the day Block Vote (Voice Vote)

  29. 2026-02-05 Finance and Appropriations

    Reported from Finance and Appropriations (15-Y 0-N)

  30. 2026-01-27 Commerce and Labor

    Committee substitute printed 26106219D-S1

  31. 2026-01-26 Commerce and Labor

    Reported from Commerce and Labor with substitute and rereferred to Finance and Appropriations (15-Y 0-N)

  32. 2026-01-26 Senate

    Senate committee offered

  33. 2026-01-26 Senate

    Senate committee offered

  34. 2026-01-19 Senate

    Presented and ordered printed 26105075D

  35. 2026-01-19 Commerce and Labor

    Referred to Committee on Commerce and Labor

Official Summary Text

Health insurance; prohibited restrictions on in-network referrals.
Prohibits a health insurance carrier from prohibiting an in-network provider, as defined in the bill, from referring any enrollee or specimen to any in-network clinical laboratory or in-network pathology service provider under the terms of such insurance unless such referral would constitute a violation of certain laws. This bill is identical to HB 424.

Current Bill Text

Read the full stored bill text
An Act to amend and reenact §
38.2-4319
of the Code of Virginia and to amend the Code of Virginia by adding in Article 1 of Chapter 34 of Title 38.2 a section numbered
38.2-3407.23
, relating to health insurance; prohibited restrictions on in-network referrals.
Be it enacted by the General Assembly of Virginia:
1. That §
38.2-4319
of the Code of Virginia is amended and reenacted and the Code of Virginia is amended by adding in Article 1 of Chapter 34 of Title 38.2 a section numbered
38.2-3407.23
as follows:
§
38.2-3407.23
. Prohibited restrictions on in-network referrals.
A. As used in this section:
"Carrier" has the same meaning as provided in §
38.2-3407.15
. "Carrier" includes any entity administering a policy or plan providing health insurance coverage to state employees pursuant to §
2.2-2818
.
"Health plan" has the same meaning as provided in §
38.2-3407.15
. "Health plan" includes any policy or plan providing health insurance coverage to state employees pursuant to §
2.2-2818
.
"In-network" means a provider that has contracted with a carrier or a carrier's contractor or subcontractor to provide health care services to enrollees and be reimbursed by the carrier at a contracted rate as payment in full for the health care services, including applicable cost-sharing requirements.
B. No carrier, in the provision of individual or group accident and sickness insurance, including any health benefit plan, shall prohibit an in-network provider from referring any enrollee or specimen to any in-network clinical laboratory or in-network pathology service provider under the terms of the health plan unless such referral would constitute a violation of the Practitioner Self-Referral Act (§
54.1-2410
et seq.) or 42 U.S.C. § 1320a-7b.
C. The Commission shall have no jurisdiction to adjudicate individual controversies arising out of this section.
§
38.2-4319
. Statutory construction and relationship to other laws.
A. No provisions of this title except this chapter and, insofar as they are not inconsistent with this chapter, §§
38.2-100
,
38.2-136
,
38.2-200
,
38.2-203
,
38.2-209
through
38.2-213
,
38.2-216
,
38.2-218
through
38.2-225
,
38.2-229
,
38.2-232
,
38.2-305
,
38.2-316
,
38.2-316.1
,
38.2-316.2
,
38.2-322
,
38.2-325
,
38.2-326
,
38.2-400
,
38.2-402
through
38.2-413
,
38.2-500
through
38.2-515
,
38.2-600
through
38.2-629
, Chapter 9 (§
38.2-900
et seq.), §§
38.2-1016.1
through
38.2-1023
,
38.2-1057
, and
38.2-1306.1
, Article 2 (§
38.2-1306.2
et seq.), §
38.2-1315.1
, and Articles 3.1 (§
38.2-1316.1
et seq.), 4 (§
38.2-1317
et seq.), 5 (§
38.2-1322
et seq.), 5.1 (§
38.2-1334.3
et seq.), and 5.2 (§
38.2-1334.11
et seq.) of Chapter 13, Articles 1 (§
38.2-1400
et seq.), 2 (§
38.2-1412
et seq.), and 4 (§
38.2-1446
et seq.) of Chapter 14, Chapter 15 (§
38.2-1500
et seq.), Chapter 17 (§
38.2-1700
et seq.), §§
38.2-1800
through
38.2-1836
,
38.2-3401
,
38.2-3405
,
38.2-3405.1
,
38.2-3406.1
,
38.2-3407.2
through
38.2-3407.6:1
,
38.2-3407.9
through
38.2-3407.20
,
38.2-3411
,
38.2-3411.2
,
38.2-3411.3
,
38.2-3411.4
,
38.2-3412.1
,
38.2-3414.1
,
38.2-3418.1
through
38.2-3418.19
,
38.2-3418.21
,
38.2-3418.22
,
38.2-3419.1
, and
38.2-3430.1
through
38.2-3454
, Articles 8 (§
38.2-3461
et seq.) and 9 (§
38.2-3465
et seq.) of Chapter 34, §
38.2-3500
, subdivision 13 of §
38.2-3503
, subdivision 8 of §
38.2-3504
, §§
38.2-3514.1
,
38.2-3514.2
,
38.2-3522.1
through
38.2-3523.4
,
38.2-3525
,
38.2-3540.1
,
38.2-3540.2
,
38.2-3541.2
,
38.2-3542
, and
38.2-3543.2
, Article 5 (§
38.2-3551
et seq.) of Chapter 35, Chapter 35.1 (§
38.2-3556
et seq.), §
38.2-3610
, Chapter 52 (§
38.2-5200
et seq.), Chapter 55 (§
38.2-5500
et seq.), Chapter 58 (§
38.2-5800
et seq.), Chapter 65 (§
38.2-6500
et seq.), and Chapter 66 (§
38.2-6600
et seq.) shall be applicable to any health maintenance organization granted a license under this chapter. This chapter shall not apply to an insurer or health services plan licensed and regulated in conformance with the insurance laws or Chapter 42 (§
38.2-4200
et seq.) except with respect to the activities of its health maintenance organization.
B. For plans administered by the Department of Medical Assistance Services that provide benefits pursuant to Title XIX or Title XXI of the Social Security Act, as amended, no provisions of this title except this chapter and, insofar as they are not inconsistent with this chapter, §§
38.2-100
,
38.2-136
,
38.2-200
,
38.2-203
,
38.2-209
through
38.2-213
,
38.2-216
,
38.2-218
through
38.2-225
,
38.2-229
,
38.2-232
,
38.2-322
,
38.2-325
,
38.2-400
,
38.2-402
through
38.2-413
,
38.2-500
through
38.2-515
, and
38.2-600
through
38.2-629
, Chapter 9 (§
38.2-900
et seq.), §§
38.2-1016.1
through
38.2-1023
,
38.2-1057
, and
38.2-1306.1
, Article 2 (§
38.2-1306.2
et seq.), §
38.2-1315.1
, Articles 3.1 (§
38.2-1316.1
et seq.), 4 (§
38.2-1317
et seq.), 5 (§
38.2-1322
et seq.), 5.1 (§
38.2-1334.3
et seq.), and 5.2 (§
38.2-1334.11
et seq.) of Chapter 13, Articles 1 (§
38.2-1400
et seq.), 2 (§
38.2-1412
et seq.), and 4 (§
38.2-1446
et seq.) of Chapter 14, §§
38.2-3401
,
38.2-3405
,
38.2-3407.2
through
38.2-3407.5
,
38.2-3407.6
,
38.2-3407.6:1
,
38.2-3407.9
,
38.2-3407.9:01
, and
38.2-3407.9:02
, subsection E of §
38.2-3407.10
, §§
38.2-3407.10:1
,
38.2-3407.11
,
38.2-3407.11:3
,
38.2-3407.13
,
38.2-3407.13:1
,
38.2-3407.14
,

38.2-3407.23
,

38.2-3411.2
,
38.2-3418.1
,
38.2-3418.2
,
38.2-3418.16
,
38.2-3419.1
,
38.2-3430.1
through
38.2-3437
, and
38.2-3500
, subdivision 13 of §
38.2-3503
, subdivision 8 of §
38.2-3504
, §§
38.2-3514.1
,
38.2-3514.2
,
38.2-3522.1
through
38.2-3523.4
,
38.2-3525
,
38.2-3540.1
,
38.2-3540.2
,
38.2-3541.2
,
38.2-3542
, and
38.2-3543.2
, Chapter 52 (§
38.2-5200
et seq.), Chapter 55 (§
38.2-5500
et seq.), Chapter 58 (§
38.2-5800
et seq.), Chapter 65 (§
38.2-6500
et seq.), and Chapter 66 (§
38.2-6600
et seq.) shall be applicable to any health maintenance organization granted a license under this chapter. This chapter shall not apply to an insurer or health services plan licensed and regulated in conformance with the insurance laws or Chapter 42 (§
38.2-4200
et seq.) except with respect to the activities of its health maintenance organization.
C. Solicitation of enrollees by a licensed health maintenance organization or by its representatives shall not be construed to violate any provisions of law relating to solicitation or advertising by health professionals.
D. A licensed health maintenance organization shall not be deemed to be engaged in the unlawful practice of medicine. All health care providers associated with a health maintenance organization shall be subject to all provisions of law.
E. Notwithstanding the definition of an eligible employee as set forth in §
38.2-3431
, a health maintenance organization providing health care plans pursuant to §
38.2-3431
shall not be required to offer coverage to or accept applications from an employee who does not reside within the health maintenance organization's service area.
F. For purposes of applying this section, "insurer" when used in a section cited in subsections A and B shall be construed to mean and include "health maintenance organizations" unless the section cited clearly applies to health maintenance organizations without such construction.