New policy will protect patients from surprise debt after treatment by out-of-network providers

RICHMOND, VA – The General Assembly approved a pair of bills on Thursday that will protect Virginians from “balance billing:” when a patient receives a surprise medical bill after being treated by a provider not covered by their insurance plan. The issue of balance billing has been receiving increasing attention in recent years and close to 30 state legislatures have enacted some level of consumer protections, with a federal compromise yet to be achieved. House Bill 1251 (Torian) and Senate Bill 172 (Favola), with identical substitutes, passed the Senate and House by 40-0 and 99-0, respectively.

Delegate Luke Torian issued the following statement: People with health insurance should be able to access health care without later finding out it wasn’t covered in the form of a surprise bill. Surprise bills can cause financial instability for Virginia families and unfairly put patients in the middle of provider-insurer disputes. I am proud we were able to come to a compromise that takes patients out of the middle, ensures doctors are reimbursed for the care they provide, and protects Virginia families.

Senator Barbara Favola issued the following statement: This is a major step forward for Virginians. I am proud to be the chief patron of a bill that will protect patients from surprise medical bills. Virginians should be able to go to the emergency room or schedule a required surgery without worrying about a medical bill that is beyond their expected deductible or co-pay. It is time to protect consumers and make our health care system work in a rational and fair manner.

HB1251 and SB172 are modeled after Washington state’s Balance Billing Protection Act. They limit a patient’s liability to their in-network cost-sharing amount and require insurers to reimburse out-of-network providers a commercially reasonable amount, with any dispute settled through arbitration. Virginia’s comprehensive solution will apply to the most common sources of balance billing and ensure care is covered regardless of final diagnosis.


Delegate Luke Torian represents House District 52 in the Virginia House of Delegates, serving Dale City, Woodbridge, and the towns of Dumfries and Occoquan. He has held office since 2009 and serves as Chair of the House Appropriations Committee. He is also a member of the House Rules and General Laws committees.