Subcommittee approves bill to bar insurer‑mandated out‑of‑network lab referrals that delay care
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Summary
By a 9–0 vote the subcommittee reported HB424, a bill to prevent carriers from overriding in‑network medical referrals in ways that delay diagnosis; sponsors and pathologists described cases where insurer‑mandated out‑of‑state lab referrals delayed cancer diagnoses.
The House Labor and Commerce subcommittee unanimously reported House Bill 424 after hearing testimony from pathologists and hospital representatives who described patient harm attributed to insurer‑mandated out‑of‑network laboratory referrals.
Sponsor Delegate LaVere Bolling said the bill places guardrails into the insurance code to ensure medical decisions for in‑network care remain between providers and patients, not insurer algorithms. He gave an example in which an in‑network pathology team was bypassed and a specimen was sent "to an out of state lab," delaying diagnosis and, he said, leading to a later emergency admission.
Pathologists including Dr. Sadia Saeed (VCU) and Dr. Eric Himmelfarb recounted cases where diagnostic delays took weeks and could have changed outcomes. Dr. Himmelfarb said in his practice referral delays "have harmed patients" and urged the committee to report the bill.
Hospitals and medical societies supported the measure; insurers noted the bill does not affect ERISA‑regulated self‑insured plans and highlighted that HMOs with limited networks are treated differently. The bill was amended to clarify coverage scope and reported with the substitute by a vote of 9–0.
The bill now moves to the next stage for fiscal and legal review.
