• Date Due: November 01, 2026
  • Author: State Corporation Commission
  • Enabling Authority: Chapter 256 Enactment Clause 1. (Regular Session, 2025)
  • Description:
    Report on the study of step therapy protocols for health benefit plans developed pursuant to § 38.2-3407.9:05 of the Code of Virginia that ascertains (i) the aggregate number of step therapy exception requests, acceptances, denials, appeals, and reversals; (ii) the percentages of reversals of step therapy exception request denials; (iii) the time frame for responses, reconsiderations, and final decisions regarding step therapy exception requests; (iv) the number of step therapy protocols that are introduced, revised, or removed each quarter; and (v) data on the specialties of step therapy protocols, such as those used specifically for oncology, rheumatology, ophthalmology, orthopedics, or neurosurgery.