Va. Code Ann. tit. 38.2, ch. 34
Va. Code Ann. tit. 38.2, ch. 34
in effectContents
section38.2-3400. Application of chaptersection38.2-3401. Forms of insurance authorizedsection38.2-3402. Certification to accompany applicationsection38.2-3403. Fraudulent procurement of policysection38.2-3404. Commission may establish rules and regulations for simplified and readable accident and sickness insurance policiessection38.2-3405. Certain subrogation provisions and limitations upon recovery in hospital, medical, etc., policies forbidden; limitations on disclosure of medical treatment options prohibitedsection38.2-3405.1. Commonwealth's right to certain accident and sickness benefitssection38.2-3406. Accident and sickness benefits not subject to legal processsection38.2-3406.1. Application of requirements that policies offered by small employers include state-mandated health benefitssection38.2-3406.2. Capped benefits under insurance policies and contractssection38.2-3407. Health benefit programssection38.2-3407.1. Interest on accident and sickness claim proceedssection38.2-3407.2. Coverage for medical child supportsection38.2-3407.3. Calculation of cost-sharing provisionssection38.2-3407.3:1. Premium payment arrearages; order of crediting paymentssection38.2-3407.4. Explanation of benefitssection38.2-3407.4:1. Repealedsection38.2-3407.4:2. Requirements for prescription benefit cardssection38.2-3407.5. Denial of benefits for certain prescription drugs prohibitedsection38.2-3407.5:1. Coverage for contraceptivessection38.2-3407.5:2. Reimbursements for dispensing hormonal contraceptivessection38.2-3407.5:3. Coverage for early refills of prescription eye dropssection38.2-3407.6. Exclusion of podiatrist not permitted under certain circumstancessection38.2-3407.6:1. Denial of benefits for certain prescription drugs prohibitedsection38.2-3407.7. Pharmacies; freedom of choicesection38.2-3407.8. Repealedsection38.2-3407.9. Reimbursement for emergency medical services vehicle transportation servicessection38.2-3407.9:01. Prescription drug formulariessection38.2-3407.9:02. Requirement for prescription drug coveragesection38.2-3407.9:03. Payment of clean claims to administrators of pharmacy benefitssection38.2-3407.9:04. Medication synchronizationsection38.2-3407.9:05. Step therapy protocolssection38.2-3407.10. Health care provider panelssection38.2-3407.10:1. Processing of new provider applications and reimbursement for services rendered during pendency of a participating provider's credentialing applicationsection38.2-3407.10:2. Credentialing of private mental health agenciessection38.2-3407.11. Access to obstetrician-gynecologistssection38.2-3407.11:1. Access to specialists; standing referralssection38.2-3407.11:2. Standing referral for cancer patientssection38.2-3407.11:3. Breast cancer underwriting and preexisting condition restrictionssection38.2-3407.11:4. Disability arising out of childbirth; minimum benefitsection38.2-3407.11:5. Interhospital transfer for newborn or mother; prior authorization prohibitedsection38.2-3407.12. Patient optional point-of-service benefitsection38.2-3407.13. Refusal to accept assignments prohibited; dentists and oral surgeonssection38.2-3407.13:1. Coordination of benefits; notice of priority of coveragesection38.2-3407.13:2. Claims paid to insureds for services from nonparticipating physicianssection38.2-3407.14. Notice of premium or deductible increasessection38.2-3407.14:1. Standard of clinical evidence for decisions on coverage for proton radiation therapysection38.2-3407.15. (Effective until January 1, 2027) Ethics and fairness in carrier business practicessection38.2-3407.15:1. Carrier contracts with pharmacy providers; required provisions; limit on termination or nonrenewalsection38.2-3407.15:2. (Effective until January 1, 2027) Carrier contracts; required provisions regarding prior authorizationsection38.2-3407.15:3. Carrier and intermediary contracts with pharmacy providers; disclosure and updating of maximum allowable cost of drugs; limit on termination or nonrenewalsection38.2-3407.15:4. Limit on copayment for prescription drugs; permitted disclosuressection38.2-3407.15:5. Limit on cost-sharing payments for prescription insulin drugssection38.2-3407.15:6. Prescription drug price transparencysection38.2-3407.15:7. Carrier provision of certain informationsection38.2-3407.15:8. (Effective January 1, 2027) Carrier contracts; required provisions regarding prior authorization for health care servicessection38.2-3407.15:9. Limit on cost-sharing payments for prescription drugs under certain planssection38.2-3407.16. Requirements for obstetrical caresection38.2-3407.17. Payment for services by dentists and oral surgeonssection38.2-3407.17:1. Payment and reimbursement practices for dental services; network accesssection38.2-3407.18. Requirements for orally administered cancer chemotherapy drugssection38.2-3407.18:1. Requirements for certain opioid antagonistssection38.2-3407.19. Payment for services by optometrists and ophthalmologistssection38.2-3407.20. Cost-sharing requirements; application of prohibition; calculation of enrollee's contributionsection38.2-3407.21. Short-term limited-duration medical planssection38.2-3407.22. Option for rebates to enrollees; protected informationsection38.2-3407.23. Prohibited restrictions on in-network referralssection38.2-3408. Policy providing for reimbursement for services that may be performed by certain practitioners other than physicianssection38.2-3409. Coverage of dependent childrensection38.2-3410. Construction of policy generally; words "physician" and "doctor" to include dentistsection38.2-3411. Coverage of newborn children requiredsection38.2-3411.1. Coverage for child health supervision servicessection38.2-3411.2. Coverage of adopted children requiredsection38.2-3411.3. Coverage for childhood immunizationssection38.2-3411.4. Coverage for infant hearing screening and related diagnosticssection38.2-3412. Repealedsection38.2-3412.1. (Effective until July 1, 2027) Coverage for mental health and substance use disorderssection38.2-3412.1:01. Repealedsection38.2-3413. Repealedsection38.2-3414. Optional coverage for obstetrical servicessection38.2-3414.1. Obstetrical benefits; coverage for maternal mental health postpartum servicessection38.2-3415. Exclusion or reduction of benefits for certain causes prohibitedsection38.2-3416. Repealedsection38.2-3417. Deductibles and coinsurance options requiredsection38.2-3418. Coverage for victims of rape or incestsection38.2-3418.1. Coverage for mammogramssection38.2-3418.1:1. Repealedsection38.2-3418.1:2. Coverage for pap smearssection38.2-3418.1:3. Cost sharing for breast examinationssection38.2-3418.2. Coverage of procedures involving bones and jointssection38.2-3418.3. Coverage for hemophilia and congenital bleeding disorderssection38.2-3418.4. Coverage for reconstructive breast surgery; notice; eligibilitysection38.2-3418.5. Coverage for early intervention servicessection38.2-3418.6. Minimum hospital stay for mastectomy and certain lymph node dissection patientssection38.2-3418.7. Coverage for prostate cancer screeningsection38.2-3418.7:1. Coverage for colorectal cancer screeningsection38.2-3418.8. Coverage for clinical trials for treatment studies on cancersection38.2-3418.9. Minimum hospital stay for hysterectomysection38.2-3418.10. Coverage for diabetessection38.2-3418.11. Coverage for hospice caresection38.2-3418.12. Coverage for hospitalization and anesthesia for dental proceduressection38.2-3418.13. Coverage for the treatment of morbid obesitysection38.2-3418.14. Coverage for lymphedemasection38.2-3418.15. Coverage for prosthetic devices and componentssection38.2-3418.15:1. Coverage for prosthetic devices and componentssection38.2-3418.16. Coverage for telemedicine servicessection38.2-3418.17. Coverage for autism spectrum disordersection38.2-3418.18. Coverage for formula and enteral nutrition products as medicinesection38.2-3418.19. Coverage for organ, eye or tissue transplantsection38.2-3418.20. Coverage for hearing aids and related services [Not in effect]section38.2-3418.21. (For contingent effective date, see Acts 2026, c. 1048, cl. 2) Coverage for hearing aids and related servicessection38.2-3418.22. (For contingent effective date, see Acts 2026, c. 1048, cl. 2) Coverage for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndromesection38.2-3418.23. Coverage for treatment of menopause and perimenopausesection38.2-3419. Additional mandated coverage made optional to group policy or contract holdersection38.2-3419.2. Inventory of mandated benefits and providerssection38.2-3420. Authority and jurisdiction of Commission; exceptionsection38.2-3421. How to show jurisdiction of other state agency or federal governmentsection38.2-3422. Examinationsection38.2-3423. When subject to this titlesection38.2-3424. Disclosure of extent and elements of coveragesection38.2-3424.1. Applicabilitysection38.2-3430.1. Application of articlesection38.2-3430.1:1. Health insurance coverage not requiredsection38.2-3430.2. Definitionssection38.2-3430.3. Guaranteed availability of individual health insurance coverage to certain individuals with prior group coveragesection38.2-3430.4. Special rules for network planssection38.2-3430.5. Application of financial capacity limitssection38.2-3430.6. Market requirementssection38.2-3430.7. Renewability of individual health insurance coveragesection38.2-3430.8. Certification of coveragesection38.2-3430.9. Regulations establishing standardssection38.2-3430.10. Effective datesection38.2-3431. Application of article; definitionssection38.2-3432. Repealedsection38.2-3432.1. Renewabilitysection38.2-3432.2. Availabilitysection38.2-3432.3. Limitation on preexisting condition exclusion periodsection38.2-3433. Repealedsection38.2-3434. Disclosure of informationsection38.2-3435. Exclusionssection38.2-3436. Eligibility to enrollsection38.2-3437. Rules used to determine group sizesection38.2-3438. Definitionssection38.2-3439. Dependent coverage for individuals to age 26section38.2-3440. Lifetime and annual limitssection38.2-3441. Rescissionssection38.2-3442. Preventive servicessection38.2-3443. Choice of a health care professionalsection38.2-3444. Preexisting condition exclusionssection38.2-3445. Patient access to emergency servicessection38.2-3445.1. Repealedsection38.2-3445.01. Balance billing for certain services; prohibitedsection38.2-3445.02. Arbitrationsection38.2-3445.03. Data sets for determining commercially reasonable paymentssection38.2-3445.04. Transparencysection38.2-3445.05. Enforcementsection38.2-3445.06. Applicability of certain sectionssection38.2-3445.07. Rules and regulationssection38.2-3446. Applicability of federal lawsection38.2-3447. Restrictions relating to premium ratessection38.2-3448. Guaranteed availabilitysection38.2-3449. Prohibiting discrimination based on health statussection38.2-3449.1. Prohibited discrimination based on gender identity or status as a transgender individualsection38.2-3450. Genetic information and testingsection38.2-3451. Essential health benefitssection38.2-3452. Waiting periodssection38.2-3453. Clinical trialssection38.2-3454. Wellness programssection38.2-3454.1. Renewal of health benefit plans; special exceptionsection38.2-3455. Definitionssection38.2-3456. Prohibited activitiessection38.2-3457. Application for registrationsection38.2-3458. Power of Commission to investigate navigatorssection38.2-3459. Grounds for termination, placing on probation, revocation, or suspension of registrationsection38.2-3460. Sufficiency of federal requirements; additional standards and qualifications for navigatorssection38.2-3461. Definitionssection38.2-3462. Comparable Health Care Service Incentive Programsection38.2-3463. Health care price transparency toolssection38.2-3464. Rules and regulations; orderssection38.2-3465. Definitionssection38.2-3466. License required to provide pharmacy benefits management services; requirements for a license, renewal, and revocation or suspension; civil penaltysection38.2-3467. (Effective until July 1, 2027) Prohibited conduct by carriers and pharmacy benefits managerssection38.2-3468. Examination of books and records; reports; access to recordssection38.2-3469. Enforcement; regulationssection38.2-3470. (Effective until July 1, 2027) Scope of article
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://law.lis.virginia.gov/vacode/title38.2/chapter34/Fetched: 10/16/2026