An Act to amend and reenact §§ 38.2-3418.21 and 38.2-3418.22 of the Code of Virginia, relating to Bureau of Insurance; essential health benefits benchmark plan selection.
HB328 amends Virginia insurance law provisions governing the state’s essential health benefits benchmark plan selection, specifically the mandated coverage sections for hearing aids and for pediatric PANS/PANDAS-related care. The bill updates § 38.2-3418.21 to require insurers, health services plans, and HMOs offering individual or group accident and sickness coverage to provide hearing-aid coverage for children age 18 and under, including one hearing aid per hearing-impaired ear every 24 months, up to $1,500 per hearing aid. It also bars copayments or other extra conditions for that coverage, requires recommendation by an otolaryngologist, and clarifies that the mandate applies to policies renewed or issued in Virginia on and after January 1, 2024, while excluding certain short-term, Medicare-related, and small-group or individual-market plans.
The bill also amends § 38.2-3418.22, which addresses coverage for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS). The text begins by refining definitions of those conditions and is part of the same insurance-mandate framework tied to Virginia’s benchmark health benefits. Overall, the legislation is aimed at ensuring that certain pediatric hearing and neuropsychiatric services are included in covered benefits under applicable health plans in the Commonwealth.
HB328 changes the scope and administration of Virginia-mandated health insurance benefits by reinforcing coverage requirements for pediatric hearing aids and related services and by revising the statutory framework for PANS/PANDAS coverage. It affects insurers, health maintenance organizations, and health services plans that issue or renew covered policies in Virginia, while preserving exclusions for Medicare-related plans, short-term policies, and certain market segments. The bill also interacts with the Bureau of Insurance’s benchmark plan responsibilities and the state’s cost-defrayal process for essential health benefits.
The available record shows no committee transcript or recorded vote history, so there is no direct evidence of debate or opposition in the materials provided. Based on the enacted chapter text, the bill appears to have advanced successfully and been approved as Chapter 1048, suggesting legislative support for the coverage mandates. The overall posture of the bill is affirmative and implementation-focused rather than contentious in the available record.
No specific points of contention are documented in the provided transcripts or votes. Potential areas that commonly raise concern in bills of this type include the cost of mandated insurance benefits, the $1,500 per hearing aid cap, the age-based limitation to children 18 and under, the exclusion of individual and small-group markets, and the requirement that services be recommended by an otolaryngologist. However, none of those issues are shown as disputed in the supplied legislative history.