The 2026 Virginia General Assembly considered many health care-related bills during the course of the most recent session. Here are some of the more notable ones. All have effective dates of July 1, 2026 unless otherwise noted.
Not to Compete Covenants
Health care professionals are added as a category of employee with whom an employer cannot enforce non-compete provisions. Further, the law defines “health care professional” as any person licensed, registered, or certified by the Board of Medicine, Nursing, Counseling, Optometry, Psychology, or Social Work. The new law also provides that any employer that violates the prohibition against covenants not to compete with a health care professional is subject to the civil penalty of $10,000 for each violation. Please note that existing agreements are grandfathered. (HB 627/SB 128)
Authorization for Physician Assistants to Practice Without a Practice Agreement
A physician assistant with at least three years of full-time clinical experience is authorized to practice without a practice agreement upon receipt of an attestation from a patient care team physician or patient care team podiatrist who provided collaboration and consultation to such physician assistant verifying the length and nature of the physician assistant’s practice. Further, the new law establishes methods for a physician assistant who is unable to obtain the required attestation to submit other evidence that the physician assistant meets the requirements to practice without a practice agreement and establishes a method for physician assistants who obtain licensure by endorsement to practice without a practice agreement if they meet the applicable requirements. The new law also establishes a scope of practice for physician assistants who practice without a practice agreement. The effective date is contingent upon the Board of Medicine adopting regulations to implement these provisions and to establish processes for granting authorization to physician assistants to practice without a practice agreement. (HB 746)
Therapeutic Interchange and Adaptation by Pharmacists
Pharmacists are authorized to perform therapeutic interchanges by substituting a drug with another drug in the same therapeutic class when such substitution lowers the cost or is cost-neutral to the patient or the prescribed drug is in a drug shortage and the substitution conforms to Board of Pharmacy regulations. Further, the Board of Pharmacy will determine which therapeutic classes of drugs shall be eligible for therapeutic interchange and which classes shall be prohibited. Pharmacists are also authorized to adapt prescriptions by changing the dosage form or quantity of a medication or by completing missing information on a prescription when there is evidence to support such change. (SB 418)
Life or Health Insurance Discrimination and Pre-exposure Prophylaxis for HIV Prevention
The bill prohibits any person from refusing to insure, refusing to continue to insure, or limiting the amount or extent of life insurance or accident and sickness insurance coverage available to an individual or charge an individual a different rate for the same coverage based solely on the status of such individual as having received pre-exposure prophylaxis for the prevention of human immunodeficiency virus. (HB 60)
Weapon Possession Prohibited in a Hospital that Provides Mental Health or Developmental Services
It is now a Class 1 misdemeanor for any person to knowingly and intentionally possess in the building of any hospital that provides mental health services or developmental services in the Commonwealth, including an emergency department or other facility rendering emergency medical care, a (i) firearm, (ii) knife with a blade over three and one-half inches, or (iii) other dangerous weapon, including explosives and stun weapons. The new law also provides that notice of such prohibitions shall be posted conspicuously at each public entrance of any hospital and that no person shall be convicted of the offense if such notice is not posted, unless such person had actual notice of the prohibitions. It further provides that such firearm, knife, explosive, or weapon shall be subject to seizure by a law-enforcement officer and forfeited to the Commonwealth and specifies certain exceptions to the prohibition. (HB 229/SB 173)
Amendments to Comprehensive Mental Health, Substance Abuse, and Developmental Disability Crisis
Services Written Plans
The Department of Behavioral Health and Developmental Services, in collaboration with the Department of Criminal Justice Services, is now allowed to amend the written plan created pursuant to relevant law after the publication of such written plan, provided that (i) the stakeholders listed in relevant law are consulted during the development of any new language to be added to such written plan and (ii) a public comment period of no less than 30 days is held prior to the finalization of such written plan. The new law also provides that the written plan shall serve as the operational framework for relevant components of the comprehensive crisis system and the Marcus Alert System and that state agencies and local implementing partners shall align their policies, procedures, and operations on an ongoing basis with the requirements and guidance set forth in the written plan. (HB 453/SB 513)
Recovery Residence Regulations
The new provisions establish certain requirements for recovery residences and directs the State Board of Behavioral Health and Developmental Services (the Board) to promulgate regulations to establish minimum certification standards for recovery residences. The law also requires that the regulations promulgated by the Department of Behavioral Health and Developmental Services (the Department) related to the certification of recovery residences include provisions that no recovery residence, or operator, employee, or agent of a recovery residence, may require a resident to participate in medical or psychological services, including clinical substance use treatment, that such recovery residence receives financial benefit from, either directly or indirectly, as a condition of entering or continuing residence at such recovery residence. It also requires the Department to monitor credentialing agencies providing credentials to recovery residences to ensure criteria related to certification comply with regulations and specifies that no such credentialing agency shall provide credentials to a recovery residence that is owned or operated by an individual who is employed by or in a position of authority at such credentialing agency, or an immediate family member of any such individual. It also requires that referrals to recovery residences made by the Department, any agency of the Commonwealth, or a court may only be made to recovery residences that are certified. (HB 931/SB 270)
Electronic Attachments to Health Insurance Claims
Effective Jan. 1, 2027, information may be submitted by a provider to a health insurance carrier through electronic attachment in the following contexts: (i) information related to services rendered as required by the carrier in its provider contract; (ii) information related to any defect or impropriety that prevents the carrier from deeming a health insurance claim a clean claim, as defined in existing law; and (iii) information required to establish medical necessity, benefit coverage, or prior authorization of services, or to conduct reconsideration activities. (HB 676)
Prior Authorization Denial Requires Physician Review
Under the new provisions, a health insurance carrier is prohibited from making an adverse determination of a prior authorization request (i) for prescription drugs unless such denial has been reviewed and approved by a licensed physician or, if a licensed physician is not available, by a licensed pharmacist or (ii) for health care services unless such adverse determination has been reviewed and approved by (a) a licensed physician; (b) in the case of mental health services, a licensed mental health provider if a licensed physician is unavailable; or (c) in the case of dental services, a licensed dentist if a licensed physician is unavailable.
(HB 481)
Downcoded Health Insurance Claims
The new law prohibits a carrier, intermediary, administrator, or representative of a carrier from downcoding a claim unless the decision to downcode is determined by a person or electronic system that reflects correct coding standards and considers all relevant patient data from the billing provider in making the determination. A carrier, intermediary, administrator, or representative that downcodes a claim is required to provide certain notice to the provider, and all downcoding dispute decisions are required to be reviewed and adjudicated by a natural person. (HB 484/SB 164)
Prescription Drug Prior Authorization
This bill amends existing required provisions for health carrier contracts related to prior authorizations for prescription drugs. Current law requires that if prior authorization is approved for prescription drugs and such prescription drugs have been scheduled, provided, or delivered to the patient consistent with the authorization, health carriers may not revoke, limit, condition, modify, or restrict that authorization except in certain circumstances. This limitation is now required on carriers to apply for the duration of the authorization, which is required to be a minimum of six months for initial authorizations and a minimum of 12 months for continued authorizations. It also adds circumstances under which a prior authorization may be revoked, limited, conditioned, modified, or restricted by a carrier, including (i) a final action by the U.S. Food and Drug Administration (FDA), other regulatory agencies, or the manufacturer communicating a patient efficacy issue that would affect the authorization and (ii) when additional safety and efficacy monitoring is clinically appropriate or recommended by the FDA, other regulatory agencies, or the manufacturer. (HB 736)
Nursing Home Change of Operator Notification
Under new requirements, a person taking over the daily operations and management of a nursing home when change of ownership or control occurs to apply to the Commissioner of Health for a change of operator license. It also establishes the requirements for the application for and for the granting of such license and establishes a civil penalty for failing to provide the Commissioner with information or documentation, effectuating a change of operator without applying for a change of operator license, or providing fraudulent information on an application for a change of operator license. (HB 717/SB 247)
Value of Charity Care in COPN Reporting
These COPN law amendments change certain limitations on the meaning of “reviewable service” as it relates to data reporting requirements for medical care facilities are removed. In addition, the new language specifies that the value of charity care for such reporting shall be based on gross patient charges. (HB 606)
Reproductive Health Care Facility Obstruction Penalties
This new law creates a Class 1 misdemeanor for any person who (i) by force or threat of force, or by physical obstruction, intentionally injures, intimidates, or interferes with, or attempts to injure, intimidate, or interfere with, another person because such other person is or has been, or in order to intimidate such person or any other person or any class of persons from, obtaining or providing reproductive health services, defined in the bill, or (ii) intentionally damages or destroys, or attempts to damage or destroy, a reproductive health care facility, defined in the bill, because such facility provides reproductive health services. It also provides that the provisions shall not be construed to place any restriction on the content of any message that anyone may wish to communicate to anyone else, either inside or outside a reproductive health care facility. (SB 137)
Medical Malpractice Information Disclosures
Insurers who issue medical malpractice liability insurance polices covering health care providers in the Commonwealth are now required to disclose, for the preceding calendar year, information regarding (i) premiums; (ii) claims activity; (iii) claim payments and litigation costs; and (iv) insurer financial condition. It further requires every medical care facility or other health care provider that maintains self-insurance, captive insurance, risk retention arrangements, or other retained financial risk for medical malpractice liability to disclose information regarding (a) the numbers of physicians and health care providers covered under the malpractice liability program; (b) claims activity; (c) malpractice expenditures; and (d) the total malpractice liability expenditures for the reporting year. In addition, such insurers, hospitals, and health care systems are required to provide a list of verdicts during the reporting year in medical malpractice actions in which the jury verdict exceeded the medical malpractice limitation on recovery. Such disclosures and information must be submitted to the State Corporation Commission’s Bureau of Insurance in a uniform format prescribed by the Bureau on or before Sept. 1, 2026, for the 2025 calendar year and on or before March 31 of each year thereafter for the preceding calendar year. (SB 536)
The printable 2026 update can be found here.
Attorneys and practice areas related to this topic include:
Jonathan M. Joseph
Rachel V. Rogers Johnson
Health Care
This item has been provided as an informational service and does not constitute legal counsel or advice, which can only be rendered in the context of specific factual situations. If a legal issue should arise, please contact an attorney listed or retain the assistance of other competent legal counsel. Case results depend on a variety of factors unique to each case and results do not guarantee or predict a similar result in any future case undertaken.