{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3418.19.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3418.19.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3418.19.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3418.19.html"}],"law_id":79176,"edition_id":1,"section_id":79176,"structure_id":14324,"section_number":"38.2-3418.19","catch_line":"Coverage for organ, eye or tissue transplant","history":"2020, cc. 217, 218, \u00a7 38.2-3418.18.","full_text":"A\n\nNotwithstanding the provisions of \u00a7 38.2-4319, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services, whose policy, contract, or plan, including any certificate of evidence of coverage issued in connection with such policy, contract, or plan, includes coverage for services related to organ, eye, or tissue transplantation as defined in \u00a7 32.1-297.2 shall not:1\n\nDeny coverage to a covered person solely on the basis of the person’s disability;2\n\nDeny a person eligibility or continued eligibility to enroll in or to renew coverage under the policy, contract, or plan for the purpose of avoiding the requirements of § 32.1-297.2;3\n\nPenalize a health care provider, reduce or limit the reimbursement of a health care provider, or provide monetary or nonmonetary incentives to a health care provider to induce such health care provider to act in a manner inconsistent with the requirements of § 32.1-297.2; or4\n\nReduce or limit coverage for services related to organ, eye, or tissue transplant as defined in § 32.1-297.2 for an eligible individual with a disability as defined in § 32.1-297.2.B\n\nThe provisions of this section shall apply to any policy, contract, or plan delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2021.C\n\nThe provisions of this section shall not apply to short-term travel, accident-only, or limited or specified disease policies; contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or federal government plans; or short-term nonrenewable policies of not more than six months’ duration.D\n\nNothing in this section shall require an insurer to provide coverage for a medically inappropriate organ, eye or tissue transplant.","order_by":null,"text":{"0":{"id":283536,"text":"Notwithstanding the provisions of \u00a7 38.2-4319, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services, whose policy, contract, or plan, including any certificate of evidence of coverage issued in connection with such policy, contract, or plan, includes coverage for services related to organ, eye, or tissue transplantation as defined in \u00a7 32.1-297.2 shall not:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":283537,"text":"Deny coverage to a covered person solely on the basis of the person’s disability;","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":283538,"text":"Deny a person eligibility or continued eligibility to enroll in or to renew coverage under the policy, contract, or plan for the purpose of avoiding the requirements of § 32.1-297.2;","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":283539,"text":"Penalize a health care provider, reduce or limit the reimbursement of a health care provider, or provide monetary or nonmonetary incentives to a health care provider to induce such health care provider to act in a manner inconsistent with the requirements of § 32.1-297.2; or","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"A4"},"4":{"id":283540,"text":"Reduce or limit coverage for services related to organ, eye, or tissue transplant as defined in § 32.1-297.2 for an eligible individual with a disability as defined in § 32.1-297.2.","type":"section","prefixes":["A","4"],"prefix":"4","entire_prefix":"A4","prefix_anchor":"A4","level":2,"prior_prefix":"A3","next_prefix":"B"},"5":{"id":283541,"text":"The provisions of this section shall apply to any policy, contract, or plan delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2021.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A4","next_prefix":"C"},"6":{"id":283542,"text":"The provisions of this section shall not apply to short-term travel, accident-only, or limited or specified disease policies; contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or federal government plans; or short-term nonrenewable policies of not more than six months’ duration.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"7":{"id":283543,"text":"Nothing in this section shall require an insurer to provide coverage for a medically inappropriate organ, eye or tissue transplant.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C"}},"ancestry":[{"id":14324,"edition_id":1,"name":"Mandated Benefits","identifier":"2","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:47:45","date_modified":"2026-06-26 03:47:45","permalink":{"id":215143,"object_type":"structure","relational_id":14324,"identifier":"2","token":"38.2\/34\/2","url":"\/38.2\/34\/2\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness 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physicians","url":"\/38.2-3408\/","token":"38.2\/34\/2\/38.2-3408","metadata":false},{"id":55621,"structure_id":14324,"section_number":"38.2-3409","catch_line":"Coverage of dependent children","url":"\/38.2-3409\/","token":"38.2\/34\/2\/38.2-3409","metadata":false},{"id":68501,"structure_id":14324,"section_number":"38.2-3410","catch_line":"Construction of policy generally; words \"physician\" and \"doctor\" to include dentist","url":"\/38.2-3410\/","token":"38.2\/34\/2\/38.2-3410","metadata":false},{"id":76551,"structure_id":14324,"section_number":"38.2-3411","catch_line":"Coverage of newborn children required","url":"\/38.2-3411\/","token":"38.2\/34\/2\/38.2-3411","metadata":false},{"id":71629,"structure_id":14324,"section_number":"38.2-3411.1","catch_line":"Coverage for child health supervision services","url":"\/38.2-3411.1\/","token":"38.2\/34\/2\/38.2-3411.1","metadata":false},{"id":70694,"structure_id":14324,"section_number":"38.2-3411.2","catch_line":"Coverage of adopted 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prohibited","url":"\/38.2-3415\/","token":"38.2\/34\/2\/38.2-3415","metadata":false},{"id":69898,"structure_id":14324,"section_number":"38.2-3416","catch_line":"Repealed","url":"\/38.2-3416\/","token":"38.2\/34\/2\/38.2-3416","metadata":false},{"id":59007,"structure_id":14324,"section_number":"38.2-3417","catch_line":"Deductibles and coinsurance options required","url":"\/38.2-3417\/","token":"38.2\/34\/2\/38.2-3417","metadata":false},{"id":81514,"structure_id":14324,"section_number":"38.2-3418","catch_line":"Coverage for victims of rape or incest","url":"\/38.2-3418\/","token":"38.2\/34\/2\/38.2-3418","metadata":false},{"id":85746,"structure_id":14324,"section_number":"38.2-3418.1","catch_line":"Coverage for mammograms","url":"\/38.2-3418.1\/","token":"38.2\/34\/2\/38.2-3418.1","metadata":false},{"id":86304,"structure_id":14324,"section_number":"38.2-3418.10","catch_line":"Coverage for 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components","url":"\/38.2-3418.15\/","token":"38.2\/34\/2\/38.2-3418.15","metadata":false},{"id":57543,"structure_id":14324,"section_number":"38.2-3418.15:1","catch_line":"Coverage for prosthetic devices and components","url":"\/38.2-3418.15_1\/","token":"38.2\/34\/2\/38.2-3418.15_1","metadata":false},{"id":61286,"structure_id":14324,"section_number":"38.2-3418.16","catch_line":"Coverage for telemedicine services","url":"\/38.2-3418.16\/","token":"38.2\/34\/2\/38.2-3418.16","metadata":false},{"id":81144,"structure_id":14324,"section_number":"38.2-3418.17","catch_line":"Coverage for autism spectrum disorder","url":"\/38.2-3418.17\/","token":"38.2\/34\/2\/38.2-3418.17","metadata":false},{"id":60567,"structure_id":14324,"section_number":"38.2-3418.18","catch_line":"Coverage for formula and enteral nutrition products as 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This law was first created in 2020. The record of its establishment is cataloged in chapters 217<\/a> and 218<\/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":[{"id":67952,"section_number":"38.2-4319","catch_line":"Statutory construction and relationship to other laws","order_by":null,"url":"\/38.2-4319\/"}],"refers_to":[{"id":54581,"section_number":"32.1-297.2","catch_line":"Discrimination prohibited","order_by":null,"url":"\/32.1-297.2\/"},{"id":67952,"section_number":"38.2-4319","catch_line":"Statutory construction and relationship to other laws","order_by":null,"url":"\/38.2-4319\/"}],"permalink":{"id":215261,"object_type":"law","relational_id":79176,"identifier":"38.2-3418.19","token":"38.2\/34\/2\/38.2-3418.19","url":"\/38.2-3418.19\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3418.19\/","token":"38.2\/34\/2\/38.2-3418.19","dublin_core":{"Title":"Coverage for organ, eye or tissue transplant","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3418.19","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Notwithstanding the provisions of \u00a7 38.2-4319<\/a>, each insurer<\/span> proposing to issue<\/span> individual or group accident and sickness insurance policies<\/span> providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts<\/span>; and each health maintenance organization providing a health care plan for health care services, whose policy, contract<\/span>, or plan, including any certificate of evidence<\/span> of coverage issued in connection with such policy, contract<\/span>, or plan, includes coverage for services related to organ, eye, or tissue transplantation as defined in \u00a7 32.1-297.2<\/a> shall not: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Deny coverage to a covered person<\/span> solely on the basis of the person<\/span>’s disability; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Deny a person<\/span> eligibility or continued eligibility to enroll in or to renew coverage under the policy, contract<\/span>, or plan for the purpose of avoiding the requirements of § 32.1-297.2<\/a>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Penalize a health care provider, reduce or limit the reimbursement of a health care provider, or provide monetary or nonmonetary incentives to a health care provider to induce such health care provider to act in a manner inconsistent with the requirements of § 32.1-297.2<\/a>; or <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Reduce or limit coverage for services related to organ, eye, or tissue transplant as defined in § 32.1-297.2<\/a> for an eligible individual with a disability as defined in § 32.1-297.2<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The provisions of this section shall apply to any policy, contract<\/span>, or plan delivered, issued for delivery, or renewed in the Commonwealth on and after January 1, 2021. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The provisions of this section shall not apply to short-term travel, accident-only, or limited or specified disease policies; contracts<\/span> designed for issuance to persons<\/span> eligible for coverage under Title XVIII of the Social Security Act, known as Medicare<\/span>, or any other similar coverage under state<\/span> or federal government plans; or short-term nonrenewable policies of not more than six months’ duration. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Nothing in this section shall require an insurer<\/span> to provide coverage for a medically inappropriate organ, eye or tissue transplant. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nCOVERAGE FOR ORGAN, EYE OR TISSUE TRANSPLANT (\u00a7 38.2-3418.19)\n\nA. Notwithstanding the provisions of \u00a7 38.2-4319, each insurer proposing to\nissue individual or group accident and sickness insurance policies providing\nhospital, medical and surgical, or major medical coverage on an expense-incurred\nbasis; each corporation providing individual or group accident and sickness\nsubscription contracts; and each health maintenance organization providing a\nhealth care plan for health care services, whose policy, contract, or plan,\nincluding any certificate of evidence of coverage issued in connection with such\npolicy, contract, or plan, includes coverage for services related to organ, eye,\nor tissue transplantation as defined in \u00a7 32.1-297.2 shall not:\n\n 1. Deny coverage to a covered person solely on the basis of the person’s\n disability;\n\n 2. Deny a person eligibility or continued eligibility to enroll in or to renew\n coverage under the policy, contract, or plan for the purpose of avoiding the\n requirements of § 32.1-297.2;\n\n 3. Penalize a health care provider, reduce or limit the reimbursement of a\n health care provider, or provide monetary or nonmonetary incentives to a\n health care provider to induce such health care provider to act in a manner\n inconsistent with the requirements of § 32.1-297.2; or\n\n 4. Reduce or limit coverage for services related to organ, eye, or tissue\n transplant as defined in § 32.1-297.2 for an eligible individual with a\n disability as defined in § 32.1-297.2.\n\nB. The provisions of this section shall apply to any policy, contract, or plan\ndelivered, issued for delivery, or renewed in the Commonwealth on and after\nJanuary 1, 2021.\n\nC. The provisions of this section shall not apply to short-term travel,\naccident-only, or limited or specified disease policies; contracts designed for\nissuance to persons eligible for coverage under Title XVIII of the Social\nSecurity Act, known as Medicare, or any other similar coverage under state or\nfederal government plans; or short-term nonrenewable policies of not more than\nsix months’ duration.\n\nD. Nothing in this section shall require an insurer to provide coverage for a\nmedically inappropriate organ, eye or tissue transplant.\n\nHISTORY: 2020, cc. 217, 218, \u00a7 38.2-3418.18.","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}}