Vol. 36 Iss. 24 - July 20, 2020

Chapter 235
Withdrawal of Proposed Regulation

REGISTRAR'S NOTICE: The State Corporation Commission is claiming an exemption from the Administrative Process Act in accordance with § 2.2-4002 A 2 of the Code of Virginia, which exempts courts, any agency of the Supreme Court, and any agency that by the Constitution is expressly granted any of the powers of a court of record.

Title of Regulation: 14VAC5-235. Rules Governing Health Insurance Balance Billing (adding 14VAC5-235-10, 14VAC5-235-20, 14VAC5-235-30).

Statutory Authority: §§ 12.1-13 and 38.2-223 of the Code of Virginia.

Notice is hereby given that the State Corporation Commission, Bureau of Insurance has WITHDRAWN the revised proposed regulatory action for 14VAC5-235, Rules Governing Health Insurance Balance Billing, that was published in 36:12 VA.R. 1750-1753 February 3, 2020. The original proposed regulatory action was published in 35:23 VA.R. 2692-2694 July 8, 2019. On June 11, 2020, the commission dismissed the action and withdrew the revised proposed regulation as described in Order of Dismissal of Case INS-2019-00081.  




CASE NO. INS-2019-00081

Ex Parte: In the matter of Adopting New
Rules Governing Health Insurance Balance Billing


On June 6, 2019, the State Corporation Commission ("Commission") commenced this proceeding by issuance of an Order To Take Notice as to new rules proposed by the Bureau of Insurance ("Bureau") to be set out under Chapter 235 of Title 14 of the Virginia Administrative Code, entitled "Rules Governing Health Insurance Balance Billing" ("Rules"), at 14 VAC 5-235-10 through 14 VAC 5-235-30.

On January 14, 2020, after receiving public comments, oral argument and legal briefs from interested persons on the Bureau's proposed Rules, the Commission issued an Order To Take Notice of Revised Proposed Rules ("January Order"). The January Order gave notice of the Bureau's revisions to the proposed Rules and directed interested persons to submit any comments or requests for a hearing on the revised proposed Rules by March 20, 2020.

On February 26, 2020, the Virginia Hospital and Healthcare Association ("VHHA") and Medical Society of Virginia ("MSV") jointly filed a Motion for Extension of Time To Submit Comments on Revised Proposed Rules ("Motion"), requesting that the Commission amend the January Order "to give all interested parties until April 20, 2020, to file comments and request a hearing regarding the Revised Proposed Rules." The VHHA and MSV cited, as the basis for their Motion, "legislation now pending before the General Assembly" that relates to health insurance balance billing and the revised proposed Rules. On March 3, 2020, the Commission granted the Motion and extended the period for commenting or requesting a hearing on the revised proposed Rules to April 24, 2020.

During the 2020 legislative session and in view of the Bureau's pending proposed Rules, the General Assembly enacted new legislation addressing health insurance balance billing: House Bill 1251 ("HB 1251"), Chapter 1080 of the 2020 Virginia Acts of Assembly; and Senate Bill 172 ("SB 172"), Chapter 1081 of the 2020 Virginia Acts of Assembly. On April 10, 2020, the Governor of Virginia signed both bills into law. The new legislation includes similar provisions as those within the Bureau's proposed rules, as well as additional protections for consumers along with responsibilities for insurance carriers, healthcare facilities, and healthcare providers.

Upon the enactment of HB 1251 and SB 172, the Commission received public comments from the Virginia Association of Health Plans, the VHHA, the MSV, the Office of the Attorney General's Division of Consumer Counsel, and the Virginia Poverty Law Center, requesting that the Bureau's revised proposed Rules be withdrawn and that this proceeding be dismissed in light of the new legislation on health insurance balance billing. The Bureau has not objected to these requests.

NOW THE COMMISSION, in its discretion and having considered the newly-enacted legislation on health insurance balance billing, which largely embodies the goals of the revised proposed Rules, the public comments, and the lack of objection from the Bureau, is of the opinion that the Bureau's revised proposed Rules should be withdrawn and this proceeding should be dismissed.

Accordingly, IT IS ORDERED THAT:

(1) The revised proposed Rules entitled "Rules Governing Health Insurance Balance Billing," recommended to be set out at 14 VAC 5-235-10 through 14 VAC 5-235-30, are withdrawn.

(2) The case is dismissed, and the papers herein shall be placed in the file for ended causes.

A COPY of this Order shall be sent by the Clerk of the Commission to: C. Meade Browder, Jr., Senior Assistant Attorney General, and Katherine C. Creef, Assistant Attorney General, Office of the Attorney General, Division of Consumer Counsel, 202 N. 9th Street, 8th Floor, Richmond, Virginia 23219-3424; and a copy hereof shall be delivered to the Commission's Office of General Counsel and the Bureau of Insurance in care of Deputy Commissioner Julie S. Blauvelt.

Agency Contact: James Young, Insurance Policy Advisor, Bureau of Insurance, State Corporation Commission, P.O. Box 1157, Richmond, VA 23218, telephone (804) 371-9612, FAX (804) 371-9944, or email

VA.R. Doc. No. R19-6030; Filed June 17, 2020, 7:11 p.m.