Health insurance; physician reimbursements, credentialing. (HB139)

Introduced By

Del. Chris Head (R-Roanoke)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Health insurance; physician reimbursements; credentialing. Requires health insurers and other carriers that credential the physicians in their provider networks to establish reasonable protocols and procedures for reimbursing a physician who has submitted a completed credentialing application to a carrier, after being credentialed by the carrier, for health care services provided to covered persons during the period in which the applicant's completed credentialing application is pending. The measure establishes minimum requirements for such protocols and procedures. The measure also (i) provides that a carrier is not required to pay reimbursement at the contracted in-network rate for any covered medical services provided by the new provider applicant if the new provider applicant's credentialing application is not approved or the carrier is otherwise not willing to contract with the new provider applicant; (ii) specifies that if a payment is made by the carrier to a physician or any entity that employs or engages the physician for a covered service, the patient is only responsible for any coinsurance, copayments, or deductibles permitted under the insurance contract with the carrier or participating provider agreement with the physician; and (iii) requires new provider applicants to provide notice to covered persons in advance of treatment. Finally, the measure requires the Virginia Department of Health to revise and reenact the regulations regarding managed care health insurance plans. Read the Bill »


Bill Has Passed


12/19/2017Prefiled and ordered printed; offered 01/10/18 18100678D
12/19/2017Referred to Committee on Commerce and Labor
01/17/2018Assigned C & L sub: Subcommittee #2
01/23/2018Impact statement from DPB (HB139)
01/23/2018Subcommittee recommends reporting (6-Y 1-N)
01/25/2018Reported from Commerce and Labor (21-Y 0-N) (see vote tally)
01/29/2018Read first time
01/30/2018Read second time and engrossed
01/31/2018Read third time and passed House BLOCK VOTE (99-Y 0-N)
01/31/2018VOTE: BLOCK VOTE PASSAGE (99-Y 0-N) (see vote tally)
02/01/2018Constitutional reading dispensed
02/01/2018Referred to Committee on Commerce and Labor
02/26/2018Reported from Commerce and Labor with substitute (7-Y 5-N) (see vote tally)
02/26/2018Committee substitute printed 18107647D-S1
02/28/2018Constitutional reading dispensed (40-Y 0-N) (see vote tally)
03/01/2018Read third time
03/01/2018Reading of substitute waived
03/01/2018Committee substitute agreed to 18107647D-S1
03/01/2018Engrossed by Senate - committee substitute HB139S1
03/01/2018Passed Senate with substitute (37-Y 3-N) (see vote tally)
03/05/2018Placed on Calendar
03/05/2018Impact statement from DPB (HB139S1)
03/05/2018Senate substitute agreed to by House 18107647D-S1 (99-Y 0-N)
03/05/2018VOTE: ADOPTION (99-Y 0-N) (see vote tally)
03/07/2018Bill text as passed House and Senate (HB139ER)
03/07/2018Impact statement from DPB (HB139ER)
03/07/2018Signed by Speaker
03/09/2018Signed by President
03/15/2018Enrolled Bill communicated to Governor on March 15, 2018
03/15/2018G Governor's Action Deadline Midnight, April 9, 2018
03/30/2018G Approved by Governor-Chapter 703 (effective 7/1/18)
03/30/2018G Acts of Assembly Chapter text (CHAP0703)


This bill was discussed on the floor of the General Assembly. Below is all of the video that we have of that discussion, 2 clips in all, totaling 5 minutes.