Health insurance; required provisions regarding prior authorization for health care services.

Removed draft metadata including the 'Senate Substitute' title, bill number, committee attribution, and patron name.

Added official 'Enrolled' status, 'Virginia Acts of Assembly' chapter header, and approval language to signify the bill has passed both legislative chambers.

The definition of 'expedited' was strengthened to explicitly include the enrollee's 'ability to regain maximum function,' and 'health care services' was clarified to exclude drugs covered under a different section.

The timeframes for carriers to respond to prior authorization requests were standardized to 72 hours for expedited cases and seven calendar days for standard cases, with clearer rules on how supplementation requests are handled.

Carriers are now prohibited from revoking an approved authorization unless the provider requests a change, fraud is involved, or a federal agency issues a safety warning, making it harder for insurers to cancel approved care.

The requirement to publicly post prior authorization lists was updated to ensure data is reported in a format compliant with federal Centers for Medicare and Medicaid Services regulations.

The exemption allowing certain health maintenance organizations (specifically those with multispecialty physician groups) to opt out of prior authorization requirements was removed.

The effective date for the prior authorization requirements was simplified to January 1, 2027, removing the previous condition that applied only to contracts entered into on or after January 1, 2026.