Healthcare (Medicaid)

in committee · Virginia · House of Delegates Feb 18, 2026

HB 1462: Medicaid and health insurance plans; supervised billing.

Supervised billing; Medicaid and health insurance plans. Requires the Department of Medical Assistance Services to permit a qualified licensed provider to bill for clinical services provided by a qualified non-licensed provider under the supervision of the qualified licensed provider and requires health insurance carriers to provide coverage for mental health services or substance use services provided by a qualified non-licensed provider under the supervision of a qualified licensed provider when such services would be covered if provided by a qualified licensed provider. Additionally, the bill reduces the time limit for a retroactive denial by a health insurance carrier from 12 months to 180 days.

Topics ✓ HealthcareSupports HealthcareMandates Medicaid/insurers to cover mental health/substance use services by non-licensed providers under supervision, expanding access and support for mental health services.95% confidence

Sub-Topics Insurance Medicaid Mental Health

Track

in committee · Virginia · Senate Feb 5, 2026

SB 483: Tribal Medicaid Advisory Group; established.

Department of Medical Assistance Services; consultation with federally recognized tribes. Establishes a Tribal Medicaid Advisory Group to work collaboratively on (i) plan amendments, waiver requests, and policies affecting tribal health programs at least 60 days prior to submitting them for public notice and comment and (ii) a tribal health program billing manual. The advisory group is required to meet in person on at least a quarterly basis. The bill also requires the Department of Medical Assistance Services to (a) recognize the eligibility of any tribal health program to participate as a provider in the state plan, (b) consult with any tribal health program participating in the state plan at least 60 days prior to taking any adverse action, including suspension of payments or investigation regarding the participation of any tribal health program in the state plan, and (c) engage in ongoing consultation with federally recognized tribes and tribal health programs to address the needs of the state and tribal governments. This bill is a recommendation of the Commission on Updating Virginia Law to Reflect Federal Recognition of Virginia Tribes.

Topics ✓ HealthcareSupports HealthcareEstablishes Tribal Medicaid Advisory Group to collaborate on policies affecting tribal health programs, ensuring tribal input in Medicaid plan amendments and billing manuals, strengthening tribal healthcare program coordination.95% confidence

Sub-Topics Medicaid Tags Tribal Nations

Track

in committee · Virginia · Senate Feb 5, 2026

SB 808: Nursing facilities; related party rent disclosures, incentive payment reduction, penalty

Nursing facilities; related party rent disclosures; incentive payment reduction; penalty. Requires any nursing facility enrolled as a Medicaid provider that makes rent or lease payments to publicly disclose information related to the rent or lease payments, including whether payments are made to a related party, the nature of the related party, and the related party rent expense, as defined in the bill. The bill requires the Department of Medical Assistance Services to determine whether related party rent expenses exceed a fair rental value benchmark and if so, deduct a portion of any incentive payment owed to the nursing facility. A knowingly false attestation or disclosure is punishable as a Class 3 misdemeanor.

Topics ✓ HealthcareSupports HealthcareRequires Medicaid nursing facilities to disclose related party rent payments, enhancing financial oversight to prevent misuse of public funds in healthcare programs.85% confidence

Sub-Topics Medicaid

Track

passed · Virginia · House of Delegates Mar 4, 2026

HB 470: Medicaid waivers; consumer-directed services, employer of record.

Department of Medical Assistance Services; Medicaid waivers; consumer-directed services; employer of record. Directs the Department of Medical Assistance Services (DMAS) to modify the program rules for consumer-directed services available through certain Medicaid waivers to allow an individual receiving services to serve as the employer of record (EOR) for his own service delivery and designate another individual to perform all or a portion of the duties of the EOR on the individual's behalf when the individual receiving services is unable to perform such duties or direct his own care. The bill specifies that when an individual (i) has not yet reached the age of majority, (ii) is ineligible to use his existing employer identification number (EIN) to facilitate the taxation of benefits, or (iii) is otherwise determined to be ineligible by DMAS by administrative rule, the EIN shall be assigned to the individual receiving services and shall not be transferred to another individual. Under the bill, DMAS has the authority to limit such amendments to specify that an individual receiving services may make such designation no more than twice per calendar year.

Topics ✓ HealthcareSupports HealthcareBill modifies Medicaid waiver rules to allow recipients to serve as employer of record for services, enhancing patient control and flexibility in care delivery within Medicaid program.95% confidence

Sub-Topics Medicaid

Track

signed · Virginia · House of Delegates Apr 13, 2026

HB 1284: State plan for medical assistance; provider-to-provider consultation.

Department of Medical Assistance Services; state plan for medical assistance; provider-to-provider consultation; telemedicine. Specifies that the Medicaid provision for provider-to-provider consultation includes payment for consultations provided through telemedicine services. This bill incorporates HB 87.

Topics ✓ HealthcareSupports HealthcareAmends state plan to allow patient-initiated consultations, improving access to specialist care without referral barriers, aligning with patient access indicators.85% confidence

Sub-Topics Medicaid Telehealth

passed · Virginia · House of Delegates Mar 3, 2026

HB 560: Administrative Process Act; appeals of case decisions regarding benefits sought, limitations.

Administrative Process Act; exemptions; limitations; appeals of case decisions regarding benefits sought. Specifies that the Administrative Process Act applies to case decisions regarding the grant or denial, including determinations of eligibility and approved levels of service, of Temporary Assistance for Needy Families, Medicaid, Supplemental Nutrition Assistance Program benefits, general relief, auxiliary grants, or state-local hospitalization. The bill also removes provisions limiting review of case decisions to ascertaining whether there was evidence in the agency record to support the case decision of the agency.

Topics ✓ HealthcareSupports HealthcareBill establishes administrative appeals process for Medicaid benefit decisions, ensuring access to healthcare coverage through proper review of denials.85% confidence

Sub-Topics Medicaid

Track

signed · Virginia · House of Delegates Apr 6, 2026

HB 1452: Medicaid; expedited review process for service authorization requests, report.

Department of Medical Assistance Services; expedited review process for Medicaid service authorization requests; report. Directs the Department of Medical Assistance Services to (i) implement expedited review of Medicaid service authorization requests consistent with applicable federal law and (ii) annually transmit the prior authorization report required by the Centers for Medicare and Medicaid Services to the Chairs of the House Committees on Appropriations and Health and Human Services and the Senate Committees on Finance and Appropriations and Education and Health.

Topics ✓ HealthcareSupports HealthcareBill establishes expedited Medicaid review for life-sustaining treatments to prevent health risks, improving patient access and protecting health rights.95% confidence

Sub-Topics Medicaid Medicare

passed · Virginia · House of Delegates Mar 4, 2026

HB 855: Medicaid; estate recoveries.

Department of Medical Assistance Services; Medicaid estate recoveries. Directs the Department of Medical Assistance Services (the Department) to limit the operation of its estate recovery program to the recovery of only federally required costs. The bill directs the Department to make information on estate recovery available on its website in multiple languages. The bill directs the Department to adopt emergency regulations to implement the provisions of the bill.

Topics ✓ HealthcareSupports HealthcareLimits Medicaid estate recovery to federally required costs, reducing financial burden on beneficiaries and protecting assets related to healthcare coverage.92% confidence

Sub-Topics Medicaid Substance Abuse

Track

in committee · Virginia · House of Delegates Feb 18, 2026

HB 136: Sickle cell disease; feasibility of Medicaid benefit and Medicaid Health Homes, report.

Department of Medical Assistance Services; sickle cell disease; feasibility of Medicaid benefit and Medicaid Health Homes; report. Directs the Department of Medical Assistance Services to determine the feasibility of participating in an optional Medicaid benefit for sickle cell disease and establishing Medicaid Health Homes to coordinate care and provide treatment for individuals with sickle cell disease. The bill requires the Department to report its findings in its annual review of sickle cell disease treatment and submit such review to the Chairmen of the House Committee on Health and Human Services and the Senate Committee on Education and Health and the Joint Commission on Health Care by November 15, 2026.

Topics ✓ HealthcareSupports HealthcareDirects feasibility study for Medicaid benefit and Health Homes for sickle cell disease, aiming to expand coverage and coordinated care access.85% confidence

Sub-Topics Medicaid

Track

passed · Virginia · House of Delegates Mar 4, 2026

HB 1495: Medicaid; oversight of services facilitation for consumer directed services.

Department of Medical Assistance Services; enhanced oversight of services facilitators. Directs the Department of Medical Assistance Services to enhance oversight of Medicaid services facilitation for consumer directed services, including incorporation of such services into the statewide Fiscal Employer Agent contract and development of a contract monitoring and oversight plan.

Topics ✓ HealthcareSupports HealthcareBill ensures continued Medicaid enrollment when facilitators fail eligibility checks, protecting access to healthcare services and preventing coverage loss for beneficiaries.95% confidence

Sub-Topics Medicaid

Track