Health Insurance

This bill changes the Code of Virginia by adding a new section about health insurance; It says it's not okay for direct primary care providers to deny referrals.

• Code of Virginia: Collection of all the laws and rules in the state of Virginia. It organizes these laws by topic, like education, transportation, or health, so people can easily find and understand the rules that affect them. It’s like the official rulebook for how things are done in Virginia.

• Primary care provider: The main doctor or nurse you go to for regular check-ups, health advice, and help with common problems. They help you stay healthy and can refer you to other doctors who have special focuses if needed.

• Referral: When a doctor or healthcare provider sends you to another specialist or service to get the care you need. For example, your regular doctor might give you a referral to see a heart specialist.

• With this change, no health insurance company can:

  • Refuse payment for any healthcare covered under a patient’s health insurance just because the request came from a primary care provider.

  • Charge a higher amount than if the referral was made by a doctor that works with the health insurance company.

• If this bill passes, a health insurance company can ask a primary care provider for proof of an agreement with the patient, which might include a written letter or a copy of the agreement along with any extra info needed.

• The goals of this bill are:

  • To make sure people who use primary care providers get the health care they need

  • To make sure health insurance companies treat all doctors fairly.