Timeline of SB 536
Below is MSV’s background on the medical malpractice cap legislation as well as a detailed 2026 timeline of negotiations.
MSV Medical Malpractice Background
In February 2024, after the Senate Finance Committee killed Senator Stanley’s bill that would have removed the malpractice cap for every plaintiff under the age of ten, Senator Obenshain approached MSV and VHHA in the hallway outside the committee and suggested we get together and come up with a plan to address the cap. The clear understanding at that time was that there was little political will left in the legislature to continue kicking the can down the road. Something had to happen.
In the Summer of 2024, MSV, VHCA, and VHHA formed an informal workgroup and engaged an actuary – Milliman – to study different cap scenarios, engage other states and stakeholders, and determine cap impacts on cost to the healthcare system. No consensus was reached, but we were able to demonstrate to legislators in the 2025 General Assembly session that we were making progress.
During the 2025 session, several key Senators and Delegates approached MSV, VTLA, and VHHA and told us in no uncertain terms that we were to meet during the off-session period and deliver a plan to in 2026 to address the medical malpractice cap. In the Spring of 2025, the MSV Board authorized MSV to reach an agreement on the cap and report on progress.
Accordingly, MSV, VHCA, VHHA, and VTLA engaged in earnest discussions during the Spring and Summer of 2025 on legislative pathways to increase the medical malpractice cap. In early Fall 2025 when discussions began to center on real numbers and terms, the VHHA suddenly insisted that it did not believe we needed to reach an agreement and stated that it did NOT have VHHA Board authorization to proceed. The good faith discussions ended, and the stakeholders entered the 2026 session without a clear plan beyond unified opposition to raising the cap.
Wed., February 11
Senate Bill 99 – removing the cap for all claims by plaintiff under the age often was carried over until the 2027 session.
Wed., February 11
Senate Bill 536 permitting the recovery of pre- judgment interest outside of or in addition to the cap was passed by the Senate 40-0.
Wed., February 18
SB 536 was reported by the civil subcommittee of the House Courts of Justice Committee by a vote of 9-1.
Thur., February 19
The Speaker’s Office summoned MSV Representative and VHHA Representative to Speaker’s office.
Speaker advised that SB 536 was going to be used as a vehicle to increase the cap.
Representatives were directed to report back to the Speaker on Monday, February 23 on what options could be considered regarding an increase to the cap.
Fri., February 20
MSV convened an emergency virtual meeting of the MSV Executive Committee.
Briefing of the above provided.
Direction given to MSV to report back to the Speaker on Monday, February 23.
Sat., February 21
VHHA Representative emailed MSV Representative at 4:25pm a 3-page email of possible medical malpractice issues to take back to the Speaker from the VHHA with a clear disclaimer that no VHHA approval of any kind had been sought or obtained.
VHHA Representative requested MSV Representative not share the details of his email and hence MSV Representative did not and will not, out of respect for another member of the bar.
MSV Representative advised VHHA Representative that there was no way “in the world the Speaker would go for this.”
MSV Representative further advised that the VTLA bottom line was that if there was no agreement, then they would seek a cap increase to $8 million dollars for every healthcare provider.
Sun., February 22
MSV Representative called VHHA Representative to discuss VHHA Representative’s email from February 21 and what VHHA Representative planned to report back to the Speaker the next day – February 23 – as the Speaker directed.
VHHA Representative asked that those conversations be kept confidential and MSV Representative would not and did not, out of respect for another member of the bar reveal those.
Mon., February 23
As directed by the Speaker on February 19, MSV Representative reported back to the Speaker the thoughts of the MSV, as directed by MSV.
Tue., February 24
Outside of a morning committee meeting in the General Assembly Building, VHHA Representative asked MSV Representative if there was a need to get back in touch with the Speaker. MSV Representative reminded VHHA Representative that the Speaker had directed both to get back in touch with the Speaker’s office on Monday, February 23. VHHA Representative said he did not understand the Monday deadline.
Wed., February 25
MSV convened an emergency virtual meeting of the Executive Committee for further briefing and gave additional directions to staff to continue to advocate for all physicians (employed and independent).
The Speaker’s office was provided with an MSV term sheet, which was reviewed with the Speaker’s COS by MSV Representative and Mr. Barrineau.
VTLA provided the Speaker’s office with a VTLA term sheet, which was subsequently provided to MSV.
The COS advised that the Speaker wanted work done to see if an agreement could be reached to reconcile the term sheets that afternoon. It was made clear that a bill raising the cap was going to pass, and it was in our interest to come to a deal.
MSV Representative asked the COS if VHHA Representative could be included in the discussions between MSV and VTLA. The COS said no.
MSV and VTLA met to review term sheets and worked into the evening drafting a single term sheet.
A preliminary agreement in principle was reached on a single cap for all health care providers and other provisions.
Thur., February 26
Early Thursday morning, MSV Representative briefed VHHA Representative on the discussions and reviewed the terms being discussed.
MSV Representative provided a written copy of the terms to VHHA Representative, as directed by the Speaker’s Office.
MSV President Dr. Mark Townsend and other board members have been contacted by and responded to Augusta Health, Bon Secours, HCA, Sentara, UVA Physician Group and VCU Health leadership.
Fri., February 27
Hospital systems reached out to MSV Representative to request the facts outlined in this timeline and to question the accuracy about what was being reported.
Outreach from COS to advise the legislation had been docketed for Monday, March 2.
At the direction of MSV President Dr. Mark Townsend, MSV staff communicated with the MSV Board, MSV members and registered physicians and PAs of VoterVoice.
An MSV Executive Committee meeting was scheduled for Monday, March 2.
Invitations to information forums are to be sent out on Monday, March 2 for meetings starting the morning of Tuesday, March 3.
Sat., February 28
The MSV Governmental Affairs team and MSV leadership responded to EVERY written communication (allegation, threat or otherwise) to correct factual misstatements and rebut accusations.
MSV President Dr. Mark Townsend spoke with Mr. Sean Connaughton of VHHA. Ms. Davis also called Mr. Connaughton.
Sun., March 1
The MSV Governmental Affairs team conducted educational sessions with VACEP, AAP and VSA, pursuant to requests from their special society lobbyists.
The team have also been contacted by and continue to share information with practices and members.
Ms. Davis spoke with Mr. Sean Connaughton.
Wed., March 4
Following passage from the Civil Subcommittee on February 18 (9 Y – 1 N), the full House Courts Committee met March 4 to hear SB536. The committee adopted a substitute. While testimony is typically only allowed in subcommittee, due to the significant changes in the substitute the Committee Chair took public comment, including from the VHHA, VTLA, MSV, Chamber of Commerce, The Doctors Company and other stakeholders.
The bill passed the full courts committee on a vote of 18 Y – 4 N.
The bill will advance to the House Floor for a vote, expected next week with strong
bipartisan support. If passed, it will go to the Senate, which must accept or reject the amended version; if rejected, a Conference Committee will attempt a compromise by March 12. If both chambers pass it, the Governor has 30 days to act; any changes will be considered on April 22.
