Accident and sickness insurance; step therapy protocols, disclosure of information. (HB362)

Introduced By

Del. Glenn Davis (R-Virginia Beach)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Step therapy protocols; disclosures. Requires health insurers that limit coverage for prescription drugs through the use of a step therapy protocol to have in place a process for a prescribing provider to request an override of the protocol for a patient. A step therapy protocol is a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition are medically appropriate for a particular patient and are covered by a health benefit plan or that conditions coverage of a prescription medication on a patient first trying an alternative medication without success. The measure requires the granting of a step therapy protocol override in certain circumstances. Finally, the measure requires an insurer that offers a health benefit plan that uses a step therapy protocol to provide (i) written notice of a determination that the protocol requires denial of coverage of a provider's selected prescription drug, (ii) an explanation of the basis for such determination, and (iii) notice of the procedures for submitting a request for an override of the restrictions of the step therapy protocol. Read the Bill »


Bill Has Failed


01/05/2016Prefiled and ordered printed; offered 01/13/16 16102438D
01/05/2016Referred to Committee on Commerce and Labor
01/19/2016Assigned C & L sub: Subcommittee #2
01/27/2016Impact statement from SCC (HB362)
01/28/2016Subcommittee recommends continuing to 2017
02/02/2016Continued to 2017 in Commerce and Labor
12/01/2016Left in Commerce and Labor

Duplicate Bills

The following bills are identical to this one: HB1755.


Deborah Grotenhuis writes:

Too bad. Now you will try three drugs and see your provider three times before you (possibly) finally get the drug that will work. Who is saving time and money with this law? Come meet my patients with Interstitial Cystitis and the others with low testosterone and watch what they, our clinic providers and we the nurses go through stepping people along. This is a bogus process.