Legislative Update for Virginia Breast Cancer Foundation
Friday March 7, 2025

Bill	Patron	Title	Synopsis	Status
HB 1765	Marty Martinez	Health Insurance; Coverage For Non-opioid Prescription Drugs.	Health insurance; coverage for non-opioid prescription drugs. Prohibits a health insurance carrier from imposing any cost-sharing, prior authorization, step therapy, or other limitation on coverage of a covered non-opioid drug approved by the U.S. Food and Drug Administration for the treatment or management of pain that is more restrictive or less favorable to the enrollee relative to a covered opioid drug approved by the U.S. Food and Drug Administration for the treatment or management of pain.	H Left in Labor and Commerce (2/5)
HB 1828	Kannan Srinivasan; Karen Keys-Gamarra; Tara A. Durant; Shelly A. Simonds	Health Insurance; Cost Sharing For Breast Examinations.	Health insurance; cost sharing for breast examinations. Prohibits health insurance carriers from imposing cost sharing for diagnostic breast examinations and supplemental breast examinations, as those terms are defined in the bill, under certain insurance policies, subscription contracts, and health care plans delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2026. The bill provides that such examinations include examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound. As introduced, this bill was a recommendation of the Health Insurance Reform Commission. This bill incorporates HB 2133 and is identical to SB 1436.	G Governor's Action Deadline 11:59 p.m., March 24, 2025 (3/3)
HB 2107	H. Otto Wachsmann, Jr.	Health Insurance; Pharmacies, Freedom Of Choice, Delivery Of Prescription Drugs, Penalties.	Health insurance; pharmacies; freedom of choice; delivery of prescription drugs; penalties. Prohibits an insurer, health maintenance organization, corporation providing preferred provider subscription contracts, or pharmacy benefits manager from imposing upon any person receiving pharmaceutical benefits any policy or practice requiring or incentivizing certain provisions relating to the delivery of prescription drugs. A violation of the bill's provisions constitutes an unfair trade practice under existing law and is subject to injunctive, penalty, and enforcement provisions in existing law.	H Left in Labor and Commerce (2/5)
HB 2133	Karen Keys-Gamarra	Health Insurance; Coverage For Breast Examinations For High-risk Individuals.	Health insurance; coverage for breast examinations for high-risk individuals. Requires health insurance carriers to cover diagnostic breast examinations and supplemental breast examinations, as those terms are defined in the bill, based on sound medical practices for any high-risk individual, as defined in the bill, without cost sharing under certain insurance policies, subscription contracts, and health care plans delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2026. The bill provides that such examinations include examinations using a health care provider's choice of diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound. This bill was incorporated in HB 1828.	H Left in Labor and Commerce (2/5)
HB 2258	Karrie K. Delaney	Bureau Of Insurance Of Scc; Step Therapy Protocols For Health Benefit Plans, Report.	Bureau of Insurance; step therapy protocols; study; report. Directs the Bureau of Insurance of the State Corporation Commission to study step therapy protocols for health benefit plans developed by insurance companies pursuant to existing law by conducting a data call of health carriers. The bill directs the Bureau to submit a summary and report of its findings and recommendations to the Governor and General Assembly by November 1, 2026.	S Passed Senate (40-Y 0-N) (2/19)
HB 2375	Mark D. Sickles	Prescription Drug Price Transparency; Pharmacy Services Administrative Organizations.	Prescription drug price transparency; pharmacy services administrative organizations. Requires pharmacy services administrative organizations to submit information on reimbursement rates and fees to the nonprofit data services organization that contracts with the Department of Health to provide prescription drug price transparency information. Under the bill, a pharmacy services administrative organization that solely generates revenue from charging flat service fees to pharmacies and does not charge pharmacies for services based on prescription drug prices or volume is exempt from submitting such information.	S Passed Senate (40-Y 0-N) (2/18)
HB 2394	Mark D. Sickles	Medicaid; Long-term Services And Supports, Presumptive Eligibility, Sunset.	Department of Medical Assistance Services; Medicaid; long-term services and supports; presumptive eligibility; sunset. Directs the Department of Medical Assistance Services to provide presumptive eligibility for Medicaid, including long-term services and supports where appropriate, to individuals who meet certain criteria. The provision of presumptive eligibility is conditional on the Department obtaining all necessary approvals and federal financial participation. The bill will sunset on January 1, 2026 if such approval and federal financial participation is not obtained.	H Left in Appropriations (2/4)
SB 1238	Tara A. Durant; Barbara A. Favola; Kannan Srinivasan; Shelly A. Simonds	Health Insurance; Cost Sharing For Breast Examinations.	Health insurance; cost sharing for breast examinations. Prohibits health insurance carriers from imposing cost sharing for diagnostic breast examinations and supplemental breast examinations, as those terms are defined in the bill, under certain insurance policies, subscription contracts, and health care plans delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2026. The bill provides that such examinations include examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound. This bill is a recommendation of the Health Insurance Reform Commission. This bill was incorporated into SB 1436.	S Incorporated by Commerce and Labor (SB1436-Perry) (15-Y 0-N) (1/27)
SB 1379	Lashrecse D. Aird	Research And Clinical Trial Cancer Consortium Initiative; Established, Report.	Health; Research and Clinical Trial Cancer Consortium Initiative established; report. Establishes the Research and Clinical Trial Cancer Consortium Initiative for the purpose of coordinating, maximizing the efficiency of, and facilitating cancer clinical research and treatment efforts across the Commonwealth. The bill establishes the membership of the Initiative to include three nonlegislative citizen members and representatives of the following institutions relating to cancer clinical research and treatment: (i) the Massey Comprehensive Cancer Center at Virginia Commonwealth University, (ii) the University of Virginia Medical Center, (iii) the Leroy T. Canoles Jr. Cancer Research Center at the Eastern Virginia Health Sciences Center at Old Dominion University, (iv) the Fralin Biomedical Research Institute at Virginia Tech Carilion, and (v) Hampton University.	S House substitute agreed to by Senate (40-Y 0-N) (2/19)
SB 1436	Tara A. Durant; Russet Perry	Health Insurance; Cost Sharing For Breast Examinations.	Health insurance; cost sharing for breast examinations. Prohibits health insurance carriers from imposing cost sharing for diagnostic breast examinations and supplemental breast examinations, as those terms are defined in the bill, under certain insurance policies, subscription contracts, and health care plans delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2026. The bill provides that such examinations include examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound. As introduced, this bill was a recommendation of the Health Insurance Reform Commission. This bill incorporates SB 1238 and is identical to HB 1828.	G Governor's Action Deadline 11:59 p.m., March 24, 2025 (2/20)