Virginia Legislation

Requires all commercial plans on market to provide coverage for at least two abuse deterrent opioids that are not subject to prior authorization in the lowest tier of the drug formulary.

This bill would amend the insurance section of state code by requiring all group plans and public employee plans to provide coverage for individuals two through twelve years old for autism spectrum disorder treatment and diagnosis. Currently coverage is only for individuals through age ten.

This bill would amend the insurance section of state code by requiring all group plans and public employee plans to extend existing autism spectrum disorder diagnosis and treatment coverage to all age groups. Currently coverage is only for individuals through age ten.

This bill would amend the insurance section of state code by requiring all group plans and public employee plans to cover autism spectrum disorder treatment and diagnosis for individuals ages two to fourteen. Currently coverage is only for individuals through age ten.

This bill amends the section of state insurance code by adding applied behavior analysis to the list of services insurers are required to cover. Additionally, the bill adds licensed behavior analyst or licensed assistant behavior analysts to providers defined under licensed mental health professionals.

This bill tried to change the section of the insurance law about autism coverage so that there would be no age limit for required treatment.

This bill tried to change the parity section of the insurance law. It would have required the following:

• Plans must “give due consideration” to recommendations of the patient’s provider regarding inpatient care and residential treatment
• Plans cannot deny coverage for inpatient care or partial hospitalization only based on their “subjective” determination that the patient is not a risk for suicide or danger to others if the patient’s provider disagrees
• If a plan denies coverage of partial hospitalization by reasoning that outpatient care would have been more appropriate but the patient already received the treatment, the plan must cover how much they would have paid for the outpatient care

Vetoed by the Governor 5/2013 (Governor’s veto message)

Among many other things, this bill tried to change the parity section of the state insurance law by clarifying that anything in this section does not apply if it conflicts with another section of the law related to implementing the Affordable Care Act. This part of the bill is identical to what is in HB 1900 from the same legislative session, which was signed into law.

This bill tried to change the section of the state insurance law about autism coverage by defining a “board certified behavior analyst” and removing the requirement that a board certified behavior analyst must be licensed by the Virginia Board of Medicine.

This bill tried to change state law so that state employee plans and other public employee plans would have to cover autism services. However, HB 2467/SB 1062 from the same legislative session, which was signed into law, did in fact accomplish this on the exact same terms that were in this bill. That section of the law is summarized at the bottom of this page under “Virginia Parity Law,” “Autism Coverage.”

This bill tried to add a section to the state insurance law about autism coverage. It is very similar to what is currently in the law (summarized at the bottom of this page under “Virginia Parity Law”, “Autism Coverage”). Here is how it is different than what is in the law now:

• Requires coverage through age 20
• Annual maximum of $36,000 for applied behavior analysis
• No exemptions for plans if premiums rise by 1%
• Does not cover services provided by a licensed clinical social worker
• Does not apply to state employee plans and other public employee plans

This bill tried to add a section to the state insurance law about autism coverage. It is very similar to what is currently in the law (summarized at the bottom of this page under “Virginia Parity Law”, “Autism Coverage”). Here is how it is different than what is in the law now:

• Requires coverage through age 9
• Annual maximum of $36,000 for applied behavior analysis
• No exemptions for plans if premiums rise by 1%

This bill tried to add a section to the state insurance law about autism coverage. It is very similar to what is currently in the law (summarized at the bottom of this page under “Virginia Parity Law”, “Autism Coverage”). The only significant difference is that it only required coverage through age 6.

This bill tried to add a section to the state insurance law about autism coverage. It is very similar to what is currently in the law (summarized at the bottom of this page under “Virginia Parity Law”, “Autism Coverage”). Here is how it is different than what is in the law now:

• Requires coverage through age 20
• Annual maximum of $36,000 for applied behavior analysis
• No exemptions for plans if premiums rise by 1%
• Does not cover services provided by a licensed clinical social worker
• Only exempts small employer fully-insured plans with 25 or fewer employees
• Does not apply to state employee plans and other public employee plans