This Act creates a special open enrollment period for persons who are already enrolled in a Medicare supplement policy or certificate to cancel their existing policy or certificate and purchase another Medicare supplement policy or certificate that provides the same or lesser benefits. Only persons who are already enrolled in a Medicare supplement policy or certificate are eligible for the special open enrollment period. The special enrollment period begins 30 days before an eligible person's birthday and remains open for at least 30 days following the eligible person's birthday. During this special open enrollment period, individuals switching from one Medicare supplement policy to another cannot be denied coverage and coverage and rates cannot be dependent upon the person’s medical history. The Act also obligates issuers to notify eligible persons who are enrolled in their Medicare supplement policies or certificates of the dates of the open enrollment period, at least 30 days before it begins, and of any modification to the benefits provided by the policy under which the person is currently insured. This Act also allows persons enrolled in a Medicare Advantage plan to cancel their existing policy, enroll in Medicare during the annual Medicare open enrollment period and apply for a Medicare supplement policy. For individuals switching from Medicare Advantage to a Medicare supplement policy, the Act prohibits issuers of Medicare supplement policies from denying applications for such policies but does allow issuers to individually rate and apply a pre-existing condition limitation.
This bill amends Delaware law to give the Department of Public Health (DPH) authority to approve supervised clinical training for mental health providers at school-based health centers. It directly affects mental health professionals seeking training placements within school health centers. The key provision establishes DPH as the official body responsible for approving these training rotations. This creates a formal process for integrating mental health provider training into school settings without altering existing center operations.
This is a Substitute for Senate Joint Resolution No. 7. Like Senate Joint Resolution No. 7, this Substitute directs the State Employees Benefits Committee (SEBC) to utilize specific strategies and policies when interacting and contracting with Pharmacy Benefit Managers (PBM) in order to achieve lower cost pharmaceutical drug benefit plans for the State. This Substitute differs from Senate Joint Resolution No. 7 by clarifying that the SEBC has a duty to consider all of the following strategies and policies when negotiating for pharmaceuticals: 1. Drug cost transparency. 2. Formation of an independent Pharmacy and Therapeutics Committee. 3. Any other supply chain tactics such as a reverse auction or transparency committee. 4. Compacts with other states to negotiate directly with drug manufacturers. 5. Paying no higher price for all drugs negotiated by Medicare. 6. Requiring PBMs disclose administrative expenses for all pharmaceutical drugs. 7. Requiring PBMs bid based on lowest pricing sources, not average wholesale price. 8. Requiring the SEBC be provided all agreements between PBMs and pharmaceutical companies when those agreements are for drugs contracted for on behalf of the SEBC. 9. Performing audits when the SEBC believes it should be entitled to information to achieve transparency or clarity. This Substitute differs from Senate Joint Resolution No. 7 by directing the SEBC to prepare a report by August 1, 2026, to summarize any difficulties in implementing any of these policies and to submit the report to the Governor; the President Pro Tempore of the Senate and Speaker of the House of Representatives, for distribution to all members of the General Assembly; the Director and the Librarian of the Division of Legislative Services; and the Public Archives.
This Act would allow for Exceptional Care for Children (ECC) to continue receiving an exemption from the nursing facility quality assessment. It is intended to be a technical clean-up bill to continue ECC's exemption once the Bridge Unit is open. The Bridge Unit will allow ECC to help a small number of individuals, who turn 21 while in ECC's care, transition from a pediatric setting to an adult setting.
This Legislation is the Delaware Pre-Authorization Reform Act of 2025. Section 1 of the Act applies to health Insurance Contracts regulated under Chapter 33 of Title 18. Section 1 provides that changes in utilization review terms for a health-care service, such as the clinical criteria used to conduct utilization reviews for a health-care service, will apply only upon re-authorization of the health-care service. Covered persons must be notified at least 6 months before any changes to utilization review terms, except in certain circumstances such as changes in clinical guideline status In addition, Section 1 sets qualifications for who may make determinations with regard to requests for pre- authorization of health-care services and appeals of adverse determinations; a timeline and required contents for the notification of an outcome of appeal of an adverse determination or a notification that additional information is necessary to make the determination of appeal; and requirements for any utilization review entity used to perform utilization review by an insurer, health-benefit plan, or health-service corporation. Section 1 also shortens the timelines for the determination of pre-authorization requests and notification to the health-care provider of the determination. For requests for pre-authorization of non-urgent health-care services not submitted electronically, the utilization review entity must notify the health-care provider within 5 business days of receipt of the request; for requests submitted electronically, notification must be given within 3 business days of receipt. For requests for pre-authorization for urgent health-care services submitted electronically, notification must be given within 24 hours of receipt. By January 1, 2027, insurers, health-benefit plans, health-service corporations, and utilization review entities must accept and respond to electronic pre-authorization requests through the same platform as the electronic request was submitted. In addition, Section 1 extends the time period that a pre-authorization is valid for from 60 days to 90 days. Finally, Section 1 provides that no more than 1 pre-authorization may be required for a single episode of care, and that if pre-authorization is granted as to a health-care service that is part of a group of services for which a bundled payment is charged, pre-authorization for the other health-care services included in the group is deemed to be approved as well. Section 2 of the Act applies to Group and Blanket Health Insurance under Chapter 35 of Title 18 and makes the same changes to pre-authorization standards and procedures that Section 1 of the Act makes to Health Insurance Contracts regulated under Chapter 33 of Title 18. Section 3 of the Act provides that the State Employee Benefits Committee established under § 9602 of the Title 29 of the Delaware Code must ensure that carriers administering plans for group health insurance comply with the requirements and provisions for pre-authorization set forth in Chapter 33, Subchapter II and Chapter 35, Subchapter V of Title 18. Section 4 of the Act provides that the Act will apply to health insurance policies, contracts, or certificates issued, modified, or renewed after December 31, 2026. Section 5 of the Act provides that the Department of Health and Social Services must, to the extent feasible, assure that contracts awarded to carriers providing health insurance relating to Medicaid assistance comply with the requirements and provisions for pre-authorization set forth in Chapter 33, Subchapter II and Chapter 35, Subchapter V of Title 18. Section 6 provides that this Act is known as the "Delaware Pre-Authorization Reform Act of 2025."
This Act makes the following updates to the Behavioral Health Consortium: - Expands the charge of the Consortium to include all aspects of behavioral health care, in addition to substance use disorder. - Adds term limits for appointed members. - Modifies the membership to remove nonoperational organizations and include representation from the Maternal and Child Death Review Board and Delaware’s Veteran community. - Removes the Behavioral Health Commission’s approval authority over the Prescription Opioid Settlement Distribution Commission’s granting and contracting processes. Additionally, this Act makes the following updates to the Prescription Opioid Settlement Distribution Commission: - Revises the Commission’s organization to reflect one Chairperson. The Commission may elect a vice chair from among its members. - Updates authorities related to the distribution of the Prescription Opioid Settlement Fund and the Prescription Opioid Impact Fund. - Ensures any reports produced by the Commission are distributed to the Behavioral Health Consortium. This Act also makes minor technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual. This Substitute differs from the original House Bill No. 169 in that it incorporates the conforming changes in House Amendment No. 1 to House Bill No. 169 directly into the body of the bill.
SB 70 amends Delaware law to allow licensed genetic counselors to directly order genetic tests, which previously required physician authorization. This change directly affects licensed genetic counselors and their patients in Delaware, streamlining access to genetic testing. The key provision removes the prior requirement that counselors obtain orders from physicians for genetic tests, enabling counselors to make these clinical decisions independently within their scope of practice.
This Act establishes the Office of Suicide Prevention to address suicide prevention and to do the following: (1) Serve in coordination with the Department of Services for Children, Youth and their Families as a place to reach all suicide prevention resources in the State. (2) Assist the suicide prevention coalition in its mission. (3) Provide suicide prevention, intervention, and postvention vision and guidance to stakeholders throughout the State. (4) Work with community level prevention organizations to promote best practices in suicide prevention, intervention, and postvention. (5) Oversee suicide prevention, intervention, and postvention funding application processes and seek grant funds to further suicide prevention, intervention, and postvention. (6) Prepare an annual report for the General Assembly and Governor that outlines the work of the Office and progress made towards suicide prevention, intervention, and postvention, beginning on October 15, 2026. (7) Create the State’s Suicide Prevention Plan, with approval of the suicide prevention coalition, and update it no fewer than every three years. The Act provides that the Division of Substance Abuse and Mental Health will choose a Director to carry out the Office’s duties.
This substitute for House Bill No. 128, like House Bill No. 128, does the following: This Act provides that the Paid Family and Medical Leave Insurance Program is the primary payor, and other paid leave benefits must be coordinated with this benefit according to the terms of the policy or procedure governing other benefits. This Act also allows disability insurance benefits to be offset by family and medical leave benefits paid to an employee pursuant to the terms of a disability insurance policy. This Act addresses private plans, and clarifies that an employer that meets its obligations under Chapter 37 of Title 19 through a private plan does not need to provide claim documentation to the Department except if there is an appeal, complaint, audit, or specific inquiry from the Department. Private plan employers with fewer than 25 employees that voluntarily elect to provide coverage under the Chapter that is otherwise exempted due to the size of their companies will be subject to all of the provisions of the Chapter. This Act establishes a Paid Leave Advisory Committee to review issues related to the implementation and administration of the Paid Family and Medical Leave Insurance Program and to review proposed statutory and regulatory amendments to the program. This substitute differs from House Bill No. 128 as follows: This substitute does not change the calculation of an application year or change the 24-month benefit period to a 12-month benefit period. This substitute adds provisions for child support garnishment of PFMLA benefits. This substitute prohibits the practice of requiring employees to use unused accrued paid time off before accessing PFMLA benefits. This substitute allows the Paid Leave Advisory Committee to begin meeting once the Delaware LaborFirst system is functional and the steering committee has been dissolved. This substitute specifies that family and medical leave benefits cannot be assigned and are exempt from the claims of creditors. This substitute sets forth procedures for executing upon judgments for amounts due under Chapter 37 of Title 19 or other titles subject to this chapter.
This Act is a substitute for Senate Bill No. 156. Like Senate Bill No. 156, this Substitute prohibits the reporting of medical debt to consumer reporting agencies and prohibits any medical debt from being included on a consumer report. Since 2023, at least 9 other states have passed laws that prohibit or restrict the reporting of medical debt on credit reports, including California, New Jersy, and Virginia. This Act differs from Senate Bill No. 156 in that it (1) adds language to the purpose section of the statute making it clear that the intent of the chapter is for medical debt not to be used in credit, employment, or housing decisions; (2) removes the proposed definition of medical debt information and instead adds a definition of medical debt; and (3) removes the proposed prohibition language on using a credit report containing medical debt information from being used when making decisions regarding someone’s credit, employment, or housing.
