CHAPTER 200
An Act to amend and reenact § 38.2-3407.15 of the Code of Virginia, relating to health insurance claims; electronic attachments accepted.
[H 676]
Approved April 6, 2026
Be it enacted by the General Assembly of Virginia:
1. That § 38.2-3407.15 of the Code of Virginia is amended and reenacted as follows:
§ 38.2-3407.15 . Ethics and fairness in carrier business practices.
A. As used in this section:
"Carrier," "enrollee," and "provider" shall have the meanings set forth in § 38.2-3407.10 ; however, a "carrier" shall also include any person required to be licensed under this title which offers or operates a managed care health insurance plan subject to Chapter 58 (§ 38.2-5800 et seq.) or which provides or arranges for the provision of health care services, health plans, networks or provider panels which are subject to regulation as the business of insurance under this title.
"Claim" means any bill, claim, or proof of loss made by or on behalf of an enrollee or a provider to a carrier (or its intermediary, administrator or representative) with which the provider has a provider contract for payment for health care services under any health plan; however, a "claim" shall not include a request for payment of a capitation or a withhold.
"Clean claim" means a claim that does all of the following: