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Health insurance; ethics and fairness in carrier business practices; downcoded claims. 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. The bill requires a carrier, intermediary, administrator, or representative that downcodes a claim to provide certain notice to the provider. The bill requires that all downcoding dispute decisions are reviewed and adjudicated by a natural person.
Introduced
Jan 12, 2026
Last Action
Mar 12, 2026
Session
VA 2026
Sponsors
1 primary · 0 co
Fiscal Impact Statement from State Corporation Commission (HB484)
Governor's Action Deadline 11:59 p.m., April 13, 2026
Enrolled Bill communicated to Governor on March 10, 2026
Enrolled
Signed by President
Signed by Speaker
Bill text as passed House and Senate (HB484ER)
Fiscal Impact Statement from State Corporation Commission (HB484)
Senate substitute agreed to by House (98-Y 0-N 0-A)
Commerce and Labor Substitute agreed to
Passed Senate with substitute Block Vote (40-Y 0-N 0-A)
Engrossed by Senate - committee substitute
Read third time
Constitutional reading dispensed Block Vote (on 2nd reading) (40-Y 0-N 0-A)
Passed by for the day Block Vote (Voice Vote)
Rules suspended
Committee substitute printed 26108293D-S1
Reported from Commerce and Labor with substitute (14-Y 0-N)
Senate committee offered
Referred to Committee on Commerce and Labor
Constitutional reading dispensed (on 1st reading)
Read third time and passed House (97-Y 1-N 0-A)
Read second time
Engrossed by House - committee substitute
committee substitute agreed to
Read first time
Committee substitute printed 26106356D-H1
Reported from Labor and Commerce with substitute (21-Y 1-N)
House subcommittee offered
Subcommittee recommends reporting with substitute (9-Y 0-N)
Assigned HCL sub: Subcommittee #1
Referred to Committee on Labor and Commerce
Prefiled and ordered printed; Offered 01-14-2026 26102714D
Get a plain-English explanation of what this bill does, who it affects, and why it matters.
Fiscal Impact Statement from State Corporation Commission (HB484)