VIRGINIA

Overview

Virginia operates an All-Payer Claims Database and provides other datasets online relating to cost and quality, including the average charge data for 25 of the most frequently reported health care services. All medical facilities and health maintenance organizations are required to submit utilization data to the Commissioner to populate the database. Virginia has been active in passing many legislations to increase healthcare transparency, for both the 2015-2016 and 2017-2018 legislative terms.

In the 2018 legislative session, Virginia passed HB 1177/SB 933, which prohibits pharmacy benefit managers from collecting a fee more than the applicable co-payment for a covered prescription and enables them to disclose the availability of a more affordable equivalent of the drug to consumers. The Legislature sought to offer short-term insurance plans through SB 844, but the Governor vetoed the measured after it passed in the House and Senate.

State Action




2020 Legislative Session: 1/8/2020 - 3/8/2020 (2020-2021 term). *Current session bill updates are ongoing. Check back weekly for updates.

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© 2018-2020 The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

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© 2018-2020 The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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Additional Resources

STATE BUDGET

Virginia operates under a two-year (biennial) budget cycle. Each year the Governor prepares the proposed budget bill for introduction by the General Assembly. The biennial budget is enacted into law in even-numbered years, and amendments to it are enacted in odd-numbered years. The budget cycle begins in July.

REGULATION & ENFORCEMENT

  • On March 21, 2014, The Virginia Attorney General, Mark R. Herring, filed an amicus brief on behalf of the Commonwealth in support of the federal government in the case of King v. Sebelius. Plaintiffs alleged that the premium assistance tax credits are only available to purchasers on state-operated exchange, not federally-operated exchanges. The Fourth Circuit Court of Appeals ultimately affirmed the lower court’s decision in King v. Burrell that purchasers on federally-operated exchanges are eligible for financial assistance.

KEY RESOURCES