Virginia House Advances Legislation Expanding Medicaid Telemedicine Access for Patient-Initiated Consultations

RICHMOND, Va. – In a unanimous vote, the Virginia House of Delegates passed House Bill 1284 on February 13, 2026, incorporating provisions from House Bill 87 to broaden access to consultations under the state Medicaid plan managed by the Department of Medical Assistance Services. The measure specifies that payments for provider-to-provider consultations will include those provided through telemedicine services, extending coverage to patient-initiated consultations, including audio-only telemedicine where applicable.

Delegate Amy Laufer introduced HB87 on January 1, 2026, directing the Department of Medical Assistance Services to modify state plan provisions. The bill aimed to include patient-generated consultations alongside existing provider-to-provider options. Prefiled and ordered printed, it was referred to the House Committee on Health and Human Services and assigned to its Social Services subcommittee on January 16.

The subcommittee reviewed a fiscal impact statement from the Department of Planning and Budget on January 28, which outlined projected costs starting in fiscal year 2027. On January 29, the subcommittee recommended incorporating HB87 with an 8-0 vote. Subsequently, on February 3, the full Health and Human Services committee incorporated HB87 into HB1284, sponsored by Delegate Mark Downey, via voice vote.

HB1284 progressed swiftly through the legislative process. After amendments and substitutes from the Social Services and Health and Human Services subcommittees, it moved to the Appropriations Committee. The Health and Human Resources subcommittee recommended reporting on February 6 with a 7-0 vote, followed by the full Appropriations Committee reporting it 22-0 on February 9. The House agreed to the committee substitute on February 12, engrossed the bill, and passed it on third reading via block vote 96-0 on February 13.

The fiscal impact statement for HB87, which applies to the incorporated provisions, projects significant expenditures for the Department of Medical Assistance Services. General fund costs begin at $745,592 in fiscal year 2027, escalating to $855,597 in 2028, $898,377 in 2029, $943,296 in 2030, and $990,461 in 2031, assuming 5 percent annual growth. Nongeneral fund impacts start at $2,282,412 in 2027, rising to $3,024,693 by 2031. These estimates draw from fiscal year 2024 costs for federally allowed audio-only communications, totaling about $3 million in the first year, with the general fund covering the state share.

The provisions address coverage for telemedicine consultations, including audio-only interactions for Medicaid, CHIP, and FAMIS members. Current coverage exists for behavioral health, mental health, mobile crisis, and substance use services under federal guidelines. The bill expands this at the provider’s discretion when patients lack video access, aligning with Centers for Medicare and Medicaid Services guidance while noting post-pandemic flexibilities that ended March 31, 2025, for most services except certain behavioral health extensions.

Following House passage, HB1284 received a constitutional reading dispense and was referred to the Senate Committee on Education and Health on February 16. Assigned to the Health subcommittee on February 24, it was reported from the full committee 15-0 on February 26 and rereferred to Finance and Appropriations, where it remains as of early March.

Proponents highlight the measure’s focus on practical enhancements to service delivery, enabling patients to initiate consultations directly, which supports efficient care coordination. By leveraging telemedicine, including accessible audio-only options, the bill addresses barriers for individuals in remote or underserved areas who may lack reliable video technology. The unanimous committee and floor support in the House underscores broad agreement on improving Medicaid plan flexibility without overhauling existing structures.

The Department of Planning and Budget noted that a budget amendment would be necessary to fund the requirements, impacting specific budget items. No significant revenue changes or local government impacts were identified. As the bill advances in the Senate, it represents a targeted update to state plan provisions, prioritizing patient access through proven telemedicine modalities amid ongoing discussions on health care delivery efficiencies.

Virginia’s Medicaid program serves hundreds of thousands, and expansions like this could streamline consultations, reducing administrative hurdles for providers and beneficiaries alike. The incorporation of HB87 into HB1284 streamlined the legislative path, reflecting committee consensus on merging complementary aims. Delegate Downey’s bill now carries forward Laufer’s initiative, positioning it for potential Senate consideration in the coming weeks of the 2026 Regular Session.