PA Reform EnactedTransparency Requirements
Virginia Prior Authorization Requirements
A guide to prior authorization rules, turnaround times, and laws for medical practices operating in Virginia (VA).
PA Turnaround Times
Standard Requests
14 calendar days
Urgent / Expedited
24 hours
PA Reform Legislation
Virginia has enacted step therapy reform and PA transparency legislation.
Key Regulations
- Standard PA turnaround of 14 calendar days
- Urgent requests within 24 hours
- Step therapy override protections
- PA criteria transparency requirements
Virginia Medicaid PA
Virginia Medicaid uses managed care through several MCOs. PA administered by MCOs under state guidelines.
Recent Changes (2025-2026)
- Step therapy reform legislation implementation
Top Payers in Virginia
Anthem Blue Cross Blue ShieldOptima HealthCareFirstUnitedHealthcareAetna
State Regulatory Body: Virginia Bureau of Insurance
File PA complaints or appeals through your state insurance department.
Automate PA in Virginia
Greenlight knows every payer's PA requirements in Virginia and checks them automatically before every appointment -- so your staff does not have to.
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