The state does have a clean claim law and with that a carrier shall pay any claim within 40 days of receipt of the claim except where the obligation of the carrier to pay a claim is not reasonably clear due to the existence of a reasonable basis supported by specific information available for review by the person submitting the claim. Litigation is expressly allowed in this law without the penalty of interest accrued for non-payment.

Link to Existing Law: Va. Code Ann. § 38.2-3407.15

PBMs fall under the broad definition of a health plan. In addition, this law is benefitted by the existence of an express private right of action, allowing for recovery of attorneys’ fees.