VirginiaHealth insurance; ethics and fairness in carrier business practices, downcoded claims.
What it does
Health insurance; ethics and fairness in carrier business practices; downcoded claims. Prohibits a carrier, intermediary, administrator, or representative of a carrier from downcoding a claim unless the decision to downcode is determined by a person or electronic system that reflects correct coding standards and considers all relevant patient data from the billing provider in making the determination. The bill requires a carrier, intermediary, administrator, or representative that downcodes a claim to provide certain notice to the provider.
More detail
The bill requires that all downcoding dispute decisions are reviewed and adjudicated by a natural person.
Where do you stand?
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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
- Apr 13Approved by Governor Abigail Spanberger-Chapter 881 (effective 7/1/2026)Became Law
- Mar 24Fiscal Impact Statement from State Corporation Commission (SB164)
- Mar 14Governor's Action Deadline 11:59 p.m., April 13, 2026To Governor
- Mar 14Enrolled Bill communicated to Governor on March 14, 2026Minor
- Mar 12Signed by PresidentMajor
- Mar 12Signed by SpeakerMajor
- Mar 12Bill text as passed Senate and House (SB164ER)Major
- Mar 12EnrolledMinor
- Mar 6House substitute with amendments agreed to by Senate (40-Y 0-N 0-A)Major
- Vote recorded Concur House Amendments R. Result: pass.Upper
- Mar 4Passed House with substitute with amendments (97-Y 1-N 0-A)Passed House
- Vote recorded H VOTE:. Result: pass.Lower
- Mar 4Engrossed by House - committee substitute as amendedMajor
- Mar 4Delegate Shin Floor amendments agreed toMajor
- Mar 4Labor and Commerce Substituteagreed to by House
- Mar 4Reconsideration of
- Mar 4Floor offered Delegate Shin Amendments
- Mar 4Passed by temporarily
- Mar 4committee substitute rejected
- Mar 4Read third timeMinor
- Mar 3Fiscal Impact Statement from State Corporation Commission (SB164)
- Mar 3Passed by for the day
- Mar 3Moved from Uncontested Calendar to Regular Calendar
- Mar 2Read second timeMinor
- Feb 27Committee substitute printed 26108190D-H1Major
- Feb 26Reported from Labor and Commerce with substitute (21-Y 0-N)Minor
- Vote recorded Reported from Labor and Commerce with substitute. Result: pass.Lower
- Feb 24Subcommittee recommends reporting with substitute (9-Y 0-N)Major
- Vote recorded Subcommittee recommends reporting with substitute. Result: pass.Lower
- Feb 19Assigned HCL sub: Subcommittee #1Minor
- Feb 4Referred to Committee on Labor and CommerceMinor
- Feb 4Read first timeMinor
- Feb 4Placed on Calendar
- Jan 30Read third time and passed SenatePassed Senate
- Vote recorded Passage R. Result: pass.Upper
- Jan 29Engrossed by Senate - committee substituteMajor
- Jan 29Engrossed by Senate (Voice Vote)
- Jan 29Commerce and Labor Substitute agreed to
- Jan 29Read second timeMinor
- Jan 28Passed by for the day
- Vote recorded Constitutional reading dispensed R. Result: pass.Upper
- Jan 28Passed by for the day Block Vote (Voice Vote)
- Jan 28Constitutional reading dispensed Block Vote (on 1st reading) (40-Y 0-N 0-A)
- Jan 28Rules suspended
- Jan 27Committee substitute printed 26106195D-S1Major
- Jan 26Reported from Commerce and Labor with substitute (15-Y 0-N)Minor
- Vote recorded Reported from Commerce and Labor with substitute. Result: pass.Upper
- Jan 26Senate committee offered
- Jan 26Senate committee offered
- Jan 7Referred to Committee on Commerce and LaborMinor
- Jan 7Prefiled and ordered printed; Offered 01-14-2026 26103299DIntroduced