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Bill

HB 864

Health insurance; coverage for therapeutic day treatment services.

2025 Regular Session Introduced by Katrina Callsen and 7 co-sponsors

Virginia would require health insurers to cover therapeutic day treatment services for mental health and substance use disorders as an alternative to hospitalization.

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Bill Summary · HB 864

Legislative bill overview

HB 864 requires health insurance plans in Virginia to cover therapeutic day treatment (TDT) services for mental health and substance use disorders. The bill mandates that insurers provide coverage for these structured outpatient treatment programs as an alternative to inpatient hospitalization or intensive residential care.

Why is this important

Therapeutic day treatment services allow individuals with mental health and addiction challenges to receive intensive clinical care while remaining in their communities and maintaining employment or family responsibilities. This addresses a gap in Virginia's mental health coverage landscape and could reduce overall healthcare costs by preventing unnecessary hospitalizations while improving treatment outcomes and quality of life.

Potential points of contention

  • Insurance cost implications: Insurers may argue that mandated coverage increases premiums for all policyholders, particularly in competitive markets where insurers operate with thin margins
  • Definition and oversight concerns: Ambiguity around what qualifies as "therapeutic day treatment" versus other outpatient mental health services could create disputes over coverage eligibility and administrative burden
  • Provider network adequacy: Rural and underserved areas may lack sufficient TDT providers, meaning the mandate creates coverage without accessible services, leaving some insured Virginians unable to access mandated care

Compiled from official sources — confirm details with the bill’s official record.

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