VirginiaPharmacy benefits managers; requirements, application of law, report, delayed effective date.
What it does
Pharmacy benefits managers; requirements; scope; report. Requires all health insurance carriers to use the pass-through pricing model and may limit a pharmacy benefits manager from deriving income from pharmacy benefits management services provided to a carrier except for income derived from a pharmacy benefits management fee. The bill prohibits a pharmacy benefits manager from (i) reversing and or resubmitting the claim of a pharmacist or pharmacy without meeting certain requirements, (ii) reducing any payment to a pharmacist or pharmacy to an effective rate of reimbursement, or (iii) retroactively denying or reducing a claim or aggregate of claims except under certain circumstances.
More detail
The bill requires the State Corporation Commission (the Commission) to examine the practice of carriers or pharmacy benefits managers requiring or inducing covered individuals to utilize pharmacy services at an affiliated pharmacy. The Commission is required to report its findings and recommendations to the General Assembly by December 1, 2027. Certain provisions of the bill have a delayed effective date of July 1, 2027. This bill incorporates SB 410 and SB 413 and is identical to HB 830.
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Where it stands
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Mar 31Acts of Assembly Chapter text (CHAP0036)Latest
- Mar 31Approved by Governor Abigail Spanberger-Chapter 36 (effective 7/1/2026)Became Law
- Mar 12Fiscal Impact Statement from State Corporation Commission (SB669)
- Mar 10Governor's Action Deadline 11:59 p.m., April 13, 2026To Governor
- Mar 10Enrolled Bill communicated to Governor on March 10, 2026Minor
- Mar 4Signed by PresidentMajor
- Mar 4Signed by SpeakerMajor
- Mar 4Bill text as passed Senate and House (SB669ER)Major
- Mar 4EnrolledMinor
- Feb 27House substitute agreed to by Senate (38-Y 0-N 0-A)Major
- Vote recorded Concur House Substitute R. Result: pass.Upper
- Feb 25Passed House with substitute (98-Y 0-N 0-A)Passed House
- Vote recorded H VOTE:. Result: pass.Lower
- Feb 25Engrossed by House - floor substitute
- Feb 25Delegate Callsen Floor substitute agreed toMajor
- Feb 25committee substitute rejected
- Feb 25Read third timeMinor
- Feb 25Floor offered Delegate Callsen Substitute
- Feb 25Floor substitute printed 26108552D-H2 (Callsen)
- Feb 24Passed by for the day
- Feb 24Moved from Uncontested Calendar to Regular Calendar
- Feb 23Read second timeMinor
- Feb 19Committee substitute printed 26108250D-H1Major
- Vote recorded Reported from Labor and Commerce with substitute. Result: pass.Lower
- Feb 19Reported from Labor and Commerce with substitute (20-Y 0-N)Minor
- Feb 12Referred to Committee on Labor and CommerceMinor
- Feb 12Read first timeMinor
- Feb 12Placed on Calendar
- Feb 10Fiscal Impact Statement from State Corporation Commission (SB669)
- Feb 6Read third time and passed Senate (40-Y 0-N 0-A)Passed Senate
- Vote recorded Passage R. Result: pass.Upper
- Feb 5Engrossed by Senate - committee substitute Block Vote (Voice Vote)Major
- Feb 5Commerce and Labor Substitute agreed to
- Feb 5Read second timeMinor
- Feb 4Passed by for the day Block Vote (Voice Vote)
- Vote recorded Constitutional reading dispensed R. Result: pass.Upper
- Feb 4Constitutional reading dispensed Block Vote (on 1st reading) (40-Y 0-N 0-A)
- Feb 4Rules suspended
- Feb 3Reported from Finance and Appropriations (15-Y 0-N)Minor
- Vote recorded Reported from Finance and Appropriations. Result: pass.Upper
- Jan 27Committee substitute printed 26106220D-S1Major
- Jan 26Incorporates SB413 (Peake)
- Vote recorded Reported from Commerce and Labor with substitute. Result: pass.Upper
- Jan 26Reported from Commerce and Labor with substitute and rereferred to Finance and Appropriations (15-Y 0-N)Minor
- Jan 26Incorporates SB410 (Peake)
- Jan 26Senate committee offered
- Jan 26Senate committee offered
- Jan 14Referred to Committee on Commerce and LaborMinor
- Jan 14Prefiled and ordered printed; Offered 01-14-2026 26105407DIntroduced