{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3407.10_2.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3407.10_2.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3407.10_2.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3407.10_2.html"}],"law_id":56463,"edition_id":1,"section_id":56463,"structure_id":12994,"section_number":"38.2-3407.10:2","catch_line":"Credentialing of private mental health agencies","history":"2019, c. 689.","full_text":"A\n\nAs used in this section, “carrier,” “covered person,” and “health benefit plan,” have the same meaning ascribed thereto in § 38.2-3407.10:1.\n\t\t\t“Mental health professional” means a person who by education and experience is professionally qualified to provide counseling interventions designed to facilitate an individual’s achievement of human development goals and remediate mental, emotional, or behavioral disorders and associated distresses that interfere with mental health and development.\n\t\t\t“Network” means a group of participating mental health professionals who provide mental health services under the carrier’s health benefit plan that requires or creates incentives for a covered person to use the participating mental health professionals.\n\t\t\t“Private mental health agency” means a practice group of mental health professionals at least one of whom is licensed under Chapter 24 (§ 54.1-2400 et seq.) of Title 54.1.B\n\nA carrier that credentials the mental health professionals in its network may establish reasonable protocols and procedures for credentialing private mental health agencies. Upon approval by a carrier of a credentialing application made by a private mental health agency, any mental health professional employed or engaged by such agency shall be deemed credentialed pursuant to the approved credentialing application of the private mental health agency. If a carrier opts to credential a private mental health agency, at a minimum the protocols and procedures established by the carrier shall:1\n\nApply only if the private mental health agency’s credentialing application is approved by the carrier; and2\n\nRequire a private mental health agency to maintain minimum audit report requirements, as determined by the Department of Behavioral Health and Developmental Services.C\n\nThe Commission shall have no jurisdiction to adjudicate individual controversies arising out of this section.","order_by":null,"text":{"0":{"id":206719,"text":"As used in this section, “carrier,” “covered person,” and “health benefit plan,” have the same meaning ascribed thereto in § 38.2-3407.10:1.\n\t\t\t“Mental health professional” means a person who by education and experience is professionally qualified to provide counseling interventions designed to facilitate an individual’s achievement of human development goals and remediate mental, emotional, or behavioral disorders and associated distresses that interfere with mental health and development.\n\t\t\t“Network” means a group of participating mental health professionals who provide mental health services under the carrier’s health benefit plan that requires or creates incentives for a covered person to use the participating mental health professionals.\n\t\t\t“Private mental health agency” means a practice group of mental health professionals at least one of whom is licensed under Chapter 24 (§ 54.1-2400 et seq.) of Title 54.1.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":206720,"text":"A carrier that credentials the mental health professionals in its network may establish reasonable protocols and procedures for credentialing private mental health agencies. Upon approval by a carrier of a credentialing application made by a private mental health agency, any mental health professional employed or engaged by such agency shall be deemed credentialed pursuant to the approved credentialing application of the private mental health agency. If a carrier opts to credential a private mental health agency, at a minimum the protocols and procedures established by the carrier shall:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"B1"},"2":{"id":206721,"text":"Apply only if the private mental health agency’s credentialing application is approved by the carrier; and","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"3":{"id":206722,"text":"Require a private mental health agency to maintain minimum audit report requirements, as determined by the Department of Behavioral Health and Developmental Services.","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"C"},"4":{"id":206723,"text":"The Commission shall have no jurisdiction to adjudicate individual controversies arising out of this section.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B2"}},"ancestry":[{"id":12994,"edition_id":1,"name":"General Provisions","identifier":"1","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214889,"object_type":"structure","relational_id":12994,"identifier":"1","token":"38.2\/34\/1","url":"\/38.2\/34\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness Insurance","identifier":"34","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214887,"object_type":"structure","relational_id":12993,"identifier":"34","token":"38.2\/34","url":"\/38.2\/34\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":57593,"structure_id":12994,"section_number":"38.2-3400","catch_line":"Application of chapter","url":"\/38.2-3400\/","token":"38.2\/34\/1\/38.2-3400","metadata":false},{"id":72072,"structure_id":12994,"section_number":"38.2-3401","catch_line":"Forms of insurance authorized","url":"\/38.2-3401\/","token":"38.2\/34\/1\/38.2-3401","metadata":false},{"id":65240,"structure_id":12994,"section_number":"38.2-3402","catch_line":"Certification to accompany application","url":"\/38.2-3402\/","token":"38.2\/34\/1\/38.2-3402","metadata":false},{"id":83988,"structure_id":12994,"section_number":"38.2-3403","catch_line":"Fraudulent procurement of policy","url":"\/38.2-3403\/","token":"38.2\/34\/1\/38.2-3403","metadata":false},{"id":65279,"structure_id":12994,"section_number":"38.2-3404","catch_line":"Commission may establish rules and regulations for simplified and readable accident and sickness insurance policies","url":"\/38.2-3404\/","token":"38.2\/34\/1\/38.2-3404","metadata":false},{"id":62539,"structure_id":12994,"section_number":"38.2-3405","catch_line":"Certain subrogation provisions and limitations upon recovery in hospital, medical, etc., policies forbidden; limitations on disclosure of medical treatment options prohibited","url":"\/38.2-3405\/","token":"38.2\/34\/1\/38.2-3405","metadata":false},{"id":84136,"structure_id":12994,"section_number":"38.2-3405.1","catch_line":"Commonwealth's right to certain accident and sickness benefits","url":"\/38.2-3405.1\/","token":"38.2\/34\/1\/38.2-3405.1","metadata":false},{"id":70730,"structure_id":12994,"section_number":"38.2-3406","catch_line":"Accident and sickness benefits not subject to legal process","url":"\/38.2-3406\/","token":"38.2\/34\/1\/38.2-3406","metadata":false},{"id":84333,"structure_id":12994,"section_number":"38.2-3406.1","catch_line":"Application of requirements that policies offered by small employers include state-mandated health benefits","url":"\/38.2-3406.1\/","token":"38.2\/34\/1\/38.2-3406.1","metadata":false},{"id":67972,"structure_id":12994,"section_number":"38.2-3406.2","catch_line":"Capped benefits under insurance policies and contracts","url":"\/38.2-3406.2\/","token":"38.2\/34\/1\/38.2-3406.2","metadata":false},{"id":76321,"structure_id":12994,"section_number":"38.2-3407","catch_line":"Health benefit programs","url":"\/38.2-3407\/","token":"38.2\/34\/1\/38.2-3407","metadata":false},{"id":66921,"structure_id":12994,"section_number":"38.2-3407.1","catch_line":"Interest on accident and sickness claim proceeds","url":"\/38.2-3407.1\/","token":"38.2\/34\/1\/38.2-3407.1","metadata":false},{"id":58079,"structure_id":12994,"section_number":"38.2-3407.10","catch_line":"Health care provider panels","url":"\/38.2-3407.10\/","token":"38.2\/34\/1\/38.2-3407.10","metadata":false},{"id":66411,"structure_id":12994,"section_number":"38.2-3407.10:1","catch_line":"Processing of new provider applications and reimbursement for services rendered during pendency of a participating provider's credentialing application","url":"\/38.2-3407.10_1\/","token":"38.2\/34\/1\/38.2-3407.10_1","metadata":false},{"id":56463,"structure_id":12994,"section_number":"38.2-3407.10:2","catch_line":"Credentialing of private mental health agencies","url":"\/38.2-3407.10_2\/","token":"38.2\/34\/1\/38.2-3407.10_2","metadata":false},{"id":82372,"structure_id":12994,"section_number":"38.2-3407.11","catch_line":"Access to obstetrician-gynecologists","url":"\/38.2-3407.11\/","token":"38.2\/34\/1\/38.2-3407.11","metadata":false},{"id":70024,"structure_id":12994,"section_number":"38.2-3407.11:1","catch_line":"Access to specialists; 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This law was first created in 2019. The record of its establishment is cataloged in chapter 689<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year.<\/p>","references":false,"refers_to":[{"id":66411,"section_number":"38.2-3407.10:1","catch_line":"Processing of new provider applications and reimbursement for services rendered during pendency of a participating provider's credentialing application","order_by":null,"url":"\/38.2-3407.10_1\/"},{"id":65440,"section_number":"54.1-2400","catch_line":"General powers and duties of health regulatory boards","order_by":null,"url":"\/54.1-2400\/"}],"permalink":{"id":214947,"object_type":"law","relational_id":56463,"identifier":"38.2-3407.10:2","token":"38.2\/34\/1\/38.2-3407.10_2","url":"\/38.2-3407.10_2\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3407.10_2\/","token":"38.2\/34\/1\/38.2-3407.10_2","dublin_core":{"Title":"Credentialing of private mental health agencies","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3407.10:2","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> As used in this section, “carrier,” “covered person<\/span>,” and “health benefit plan,” have the same meaning ascribed thereto in § 38.2-3407.10:1<\/a>.\n\t\t\t“Mental health professional<\/span>” means a person<\/span> who by education and experience is professionally qualified to provide counseling interventions designed to facilitate an individual’s achievement of human development goals and remediate mental, emotional, or behavioral disorders and associated distresses that interfere with mental health and development.\n\t\t\t“Network<\/span>” means a group of participating mental health professionals<\/span> who provide mental health services under the carrier’s health benefit plan that requires or creates incentives for a covered person<\/span> to use the participating mental health professionals<\/span>.\n\t\t\t“Private mental health agency<\/span>” means a practice group of mental health professionals<\/span> at least one of whom is licensed under Chapter 24 (§ 54.1-2400<\/a> et seq.) of Title 54.1. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> A carrier that credentials the mental health professionals<\/span> in its network<\/span> may establish reasonable protocols and procedures for credentialing private mental health agencies. Upon approval by a carrier of a credentialing application made by a private mental health agency<\/span>, any mental health professional<\/span> employed or engaged by such agency shall be deemed credentialed pursuant to the approved credentialing application of the private mental health agency<\/span>. If a carrier opts to credential a private mental health agency<\/span>, at a minimum the protocols and procedures established by the carrier shall: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Apply only if the private mental health agency<\/span>’s credentialing application is approved by the carrier; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Require a private mental health agency<\/span> to maintain minimum audit report requirements, as determined by the Department of Behavioral Health and Developmental Services. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The Commission<\/span> shall have no jurisdiction<\/span> to adjudicate<\/span> individual controversies arising out of this section. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nCREDENTIALING OF PRIVATE MENTAL HEALTH AGENCIES (\u00a7 38.2-3407.10:2)\n\nA. As used in this section, “carrier,” “covered person,”\nand “health benefit plan,” have the same meaning ascribed thereto in\n§ 38.2-3407.10:1.\n\t\t\t“Mental health professional” means a person who by education and\nexperience is professionally qualified to provide counseling interventions\ndesigned to facilitate an individual’s achievement of human development\ngoals and remediate mental, emotional, or behavioral disorders and associated\ndistresses that interfere with mental health and development.\n\t\t\t“Network” means a group of participating mental health\nprofessionals who provide mental health services under the carrier’s\nhealth benefit plan that requires or creates incentives for a covered person to\nuse the participating mental health professionals.\n\t\t\t“Private mental health agency” means a practice group of mental\nhealth professionals at least one of whom is licensed under Chapter 24 (§\n54.1-2400 et seq.) of Title 54.1.\n\nB. A carrier that credentials the mental health professionals in its network may\nestablish reasonable protocols and procedures for credentialing private mental\nhealth agencies. Upon approval by a carrier of a credentialing application made\nby a private mental health agency, any mental health professional employed or\nengaged by such agency shall be deemed credentialed pursuant to the approved\ncredentialing application of the private mental health agency. If a carrier opts\nto credential a private mental health agency, at a minimum the protocols and\nprocedures established by the carrier shall:\n\n 1. Apply only if the private mental health agency’s credentialing\n application is approved by the carrier; and\n\n 2. Require a private mental health agency to maintain minimum audit report\n requirements, as determined by the Department of Behavioral Health and\n Developmental Services.\n\nC. The Commission shall have no jurisdiction to adjudicate individual\ncontroversies arising out of this section.\n\nHISTORY: 2019, c. 689.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}