A BILL to amend and reenact § 32.1-137.05 of the Code of Virginia, relating to health care providers; required estimate for nonemergency health care services.
HB1276 amends Virginia Code § 32.1-137.05 to expand and clarify price-transparency and patient-estimate requirements for nonemergency health care services. The bill requires hospitals to make standard charges available on their websites in a machine-readable file and, upon request made at least three days before a scheduled elective procedure, test, or other nonemergency service, to provide a written good faith estimate of the amount the patient is expected to owe.
The estimate must be based on the patient’s health plan information, information reasonably available to the provider, and the provider’s standard charges. It must describe the scheduled service, list the standard charge for the service and related items or services, and include a disclaimer that the estimate is not a contract or guarantee and that actual charges may differ based on changes in services or claim processing. The bill also requires hospitals to post notice of the patient’s right to request an estimate in conspicuous public areas and on their websites.
The bill would modify existing Virginia law governing hospital charge transparency and patient billing estimates by adding more explicit requirements for written good faith estimates and public notice. It affects hospitals and other hospital providers, and it references health benefit plans and health carriers in defining how estimates are prepared and how inaccuracies in patient-provided insurance information are handled. The measure does not create a binding price guarantee, but it strengthens disclosure obligations and patient access to pricing information for nonemergency care.
The available legislative history suggests broad support in committee, as the bill was continued to the next session in Commerce and Labor on a unanimous 15-0 vote. There are no recorded floor votes or committee transcript snippets indicating opposition in the provided materials. Overall, the bill appears to have been treated as a consumer-transparency measure with little visible controversy in the available record.
The main policy tension in the bill is between improving patient cost transparency and avoiding an obligation for providers to guarantee final charges or determine network status with certainty. The bill explicitly protects providers from liability when patients or health carriers supply incomplete or inaccurate insurance information, and it states that estimates are not warranties or binding agreements. Any potential concern would likely come from providers worried about administrative burden or from patients seeking more precise billing certainty, but no direct opposition is shown in the provided history.