Relating to patient-centered treatment flexibility within the Public Employees Insurance Agency
HB 4965 allows state employees and retirees covered by the Public Employees Insurance Agency (PEIA) to switch to an alternative medical treatment for the same diagnosed condition without needing new pre-approval, provided the alternative is medically appropriate and costs no more than the originally authorized treatment. The bill requires healthcare providers to document the medical necessity of the switch and ensures PEIA cannot deny coverage solely for not having separate pre-approval. It does not change existing covered benefits or affect treatments for new conditions, and PEIA may still deny claims for fraud or improper billing. This policy aims to reduce delays in care while maintaining cost control for the insurance program.
Bill status
signed
all 5 stages cleared
Introduction
Jan 2026
Committee Review
Mar 2026
House of Delegates Passage
Mar 2026
Senate Passage
Mar 2026
Signed into Law
Jun 2026
Introduced Jan 29, 2026
Signed Jun 29, 2026
Maddy AI version diff · 3 comparisons
What changed between versions
Committee Substitute
→
Engrossed Committee Substitute
·
3 edits
·
Mar 12, 2026
MINOR
The bill's title and version history were updated to reflect the latest legislative status. A significant explanatory note regarding the bill's purpose was removed, likely to streamline the document or align with standard formatting. The bill's core policy content regarding patient treatment flexibility remains unchanged.
TECHNICAL
Removed the explanatory note detailing the bill's purpose and the legend for strike-throughs and underlining.
Updated the version history links to reflect the current status as 'Engrossed Version' and 'Committee Substitute'.
Added a header indicating the bill is 'ENGROSSED'.
Floor votes · Senate Mar 12, 2026 · House of Delegates Mar 4, 2026
How they voted
32–0
Passed · 1 other
Total votes 33
Mar 12, 2026
D
Democratic2
100% Yea
R
Republican31
96% Yea
Vote distribution
All Yea
All Nay
Mixed
No data
Full legislative history
Actions timeline
Total actions
33
Key actions
7
Committee
5
Apr 1, 2026
Signed into law
Approved by Governor 3/31/2026
lower
Mar 14, 2026
Signed into law
Approved by Governor 3/31/2026 - House Journal
lower
Mar 14, 2026
Signed into law
Approved by Governor 3/31/2026 - Senate Journal
upper
Mar 12, 2026
Upper · Passed
Passed Senate (Roll No. 497)
upper
Mar 10, 2026
Upper · Passed
Reported do pass
upper
Mar 5, 2026
Committee
To Health and Human Resources
upper
Mar 5, 2026
Introduced
Introduced in Senate
upper
Mar 4, 2026
Lower · Passed
Passed House (Roll No. 290)
lower
Mar 2, 2026
Lower · Passed
By substitute, do pass
lower
Jan 29, 2026
Committee
To House Health and Human Resources
lower
Jan 29, 2026
Introduced
Introduced in House
lower
Jan 29, 2026
Committee
To Health and Human Resources
lower
1 primary · 2 co-sponsors
Sponsors
Role
Legislator
Party
State
District
P
Laura Kimble
RRepublican
Co
Adam Vance
RRepublican
Co
Margitta Mazzocchi
RRepublican
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