Health insurance; requirements for certain opioid antagonists.

The document format was updated to reflect final legislative approval, including the addition of 'VIRGINIA ACTS OF ASSEMBLY - 2026 SESSION', 'CHAPTER 424', and the approval date of April 8, 2026.

The document structure was altered to include 'HOUSE SUBSTITUTE' headers and tracking numbers, while the actual legal text of the bill was preserved without substantive changes.

Removed the mandate requiring insurers to place nonprescription opioid antagonists on their prescription drug formularies.

Removed the specific requirement that cost-sharing for nonprescription opioid antagonists must not exceed the cost-sharing for prescription versions.

Changed the committee attribution from 'Senate Committee on Commerce and Labor' to 'House Committee on Labor and Commerce'.

Removed the instruction to amend and reenact existing section 38.2-4319.

Coverage requirements now explicitly include at least one nonprescription opioid antagonist used for overdose reversal, in addition to the existing requirement for at least one prescription opioid antagonist.

Cost-sharing rules were updated to ensure that cost-sharing for nonprescription opioid antagonists does not exceed the amount charged for prescription opioid antagonists on the lowest cost tier.

The bill structure changed from an 'Enrolled' act to a 'Commerce and Labor Substitute' amendment, altering the legislative text and section numbering while maintaining the core policy intent.

The existing statutory construction section (§ 38.2-4319) was amended to add references to the new opioid antagonist coverage sections, ensuring the new mandate is legally integrated with other insurance laws.

The mandate to cover nonprescription (over-the-counter) naloxone was removed, leaving only the requirement to cover prescription opioid antagonists on the lowest cost tier.

A new provision was added stating that the coverage mandate does not apply to the individual and small group markets if the benefit is included in the Commonwealth's Essential Health Benefits benchmark plan.

The section number was changed from 38.2-3412.2 to 38.2-3407.18:1 to align with the existing Opioid Treatment Act chapter.