This Act clarifies that individual, group, and blanket health insurance carriers must provide for and pay for services (including immunizations) that were recommended by the Advisory Committee on Immunization Practices of the Center for Disease Control (CDC) and the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA) that were in effect as of January 1, 2025. They must also cover immunizations that were supported by national clinical guidelines or national standards of care in effect on January 1, 2025. To that end, this Act removes provisions that permit carriers to deny coverage for these items or services simply because they are not currently recommended by the Advisory Committee on Immunization Practices of the CDC and the comprehensive guidelines supported by the HRSA. This Act also removes obsolete United States Preventative Task Force provisions related to breast cancer screening from 2009.
This Act modernizes Delaware’s pharmacy practice laws by authorizing pharmacists to practice to the full extent of their education and training. Pharmacists have the expertise necessary to provide patient care beyond what current Delaware law allows, and enabling them to do so is an important step toward expanding access to health care in this State. Under this Act, pharmacists are permitted to independently evaluate patients, identify health conditions, order and prescribe laboratory tests, and prescribe drugs or devices without reliance on statewide protocols, formularies, or specified lists of conditions. Pharmacists may not prescribe controlled substances, with the exception of medications for the treatment of opioid use disorder, which pharmacists may only prescribe under a standing order from the Division of Public Health. In order to enable pharmacists to prescribe medications for the treatment of opioid use disorder under a standing order, this Act also amends the Uniform Controlled Susbstances Act in Chapter 47 of Title 16 to include “pharmacist” in the definition of “practitioner.” To ensure continuity of care, this Act also establishes requirements for documentation of treatment and communication with primary care providers. This Act takes effect immediately, but implementation is delayed by up to 1 year to give the Board of Pharmacy time to implement necessary regulations. This Act does not affect current law regarding the use of statewide protocols, standing orders, or collaborative practice agreements. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
This Joint Resolution directs the Department of Health & Social Services to explore and consider additional solutions for tackling the State's high cost of health care and to submit a report to the General Assembly by January 1, 2027, that explores the feasibility of additional strategies to lower health care costs. The report will explore updating the current Medicaid outlier methodology, ways to ensure further cost savings for 2027, and the feasibility of a statewide adoption of a global budget or 2-sided risk models, and will evaluate options for a public option or other publicly sponsored coverage strategy.
This Act protects Delaware’s nonprofit acute care hospitals from acquisition by entities other than charities or not-for-profit entities during a moratorium period. It also permanently subjects the sale or encumbrance of primary facility real estate of a nonprofit acute care hospital to the Attorney General notice and review requirements of the Conversion Act. Section 1 makes two primary changes to the definitions in § 2531 of Title 29. First, it clarifies that a "not-for-profit healthcare conversion transaction" includes those undertaken "directly or indirectly through one or more affiliates." This ensures that the Attorney General’s oversight cannot be circumvented by structuring transactions through shell entities or intermediaries. It provides a new, permanent category of conversion transaction: the sale, transfer, conveyance or lease of a hospital's "primary facility real estate" to a for-profit entity. This change ensures that arrangements involving the land and buildings of an acute care hospital are subject to the same notice and review requirements as a change in corporate control. Finally, Section 1 defines for "acute care hospital" and "primary facility real estate.” Section 2 requires the Attorney General to transmit copies of any Conversion Act notice involving an acute care hospital to the Governor and the Secretary of the Department of Health and Social Services within 10 days of receipt. Section 3 prohibits any person or entity, other than a charity or not-for-profit entity, from entering into a "change of control transaction" involving acquisition of a nonprofit acute care hospital. It defines a "change of control transaction" as the acquisition of the power to direct the hospital's management, policies, or clinical practices, whether through ownership of voting securities, changes in board composition, or by contract. Any transaction of this nature is void and has no legal effect. The prohibition expressly captures incremental acquisition scenarios, including minority stakes, sub-majority governance rights, board appointment rights, and executive officer appointment rights. Section 4 amends § 9304 of Title 16 to prohibit any entity or person other than a charity or not-for-profit entity from submitting, and the Health Resources Board from accepting or processing, an application for a Certificate of Public Review for the construction, development, establishment, or acquisition of an acute care hospital. Any such application is void and of no legal effect. Section 5 provides that Sections 2 through 4 are effective until July 1, 2028, unless terminated sooner or extended by the General Assembly.
This Act does all of the following: (1) Establishes a regulatory framework for substance use harm reduction programs that provides immunities for program providers and staff. (2) Modifies the definition of drug paraphernalia. (3) Decriminalizes possession of paraphernalia for individuals who use drugs, while retaining prohibitions for paraphernalia used in the manufacturing or distribution of drugs and the selling of certain drug paraphernalia. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
This Act revises Delaware law governing behavioral health treatment provider organizations by establishing a comprehensive statutory framework governing licensing, oversight, enforcement, client rights, provider duties, incident reporting, and investigations relating to behavioral health treatment services. The Act consolidates and modernizes statutory provisions governing behavioral health treatment oversight and clarifies the Division of Substance Abuse and Mental Health's authority to license programs, investigate incidents, and enforce compliance with this chapter. This Act is a substitute for and differs from Senate Bill No. 161 by doing all of the following: (1) Expands the definition of the protection and advocacy system to reference all applicable federal protection and advocacy statutes. (2) Revises the client rights provisions by reorganizing and clarifying the rights framework, adding rights related to discharge planning and continuing care, clarifying the standard for permissible limitations on client rights, including a requirement that any limitation be for the shortest duration feasible, and revising the standard governing the use of restrictive intervention to align with existing Delaware law. (3) Expands standing to enforce client rights to include clients and their authorized representatives in addition to the Attorney General and the protection and advocacy system. (4) Adds a savings clause clarifying that nothing in this Act abrogates the rights and requirements applicable to long-term care facilities under Chapter 11 of Title 16. (5) Adds elopement to the definition of incident for purposes of the incident reporting requirements. (6) Modifies the provisions relating to the protection and advocacy system by expanding the system's access authority to reference all applicable federal and State law, adding a requirement that the Division notify the protection and advocacy system no more than 72 hours after receiving a report of a client death, authorizing staff to make discretionary reports to the protection and advocacy system, and extending anti-retaliation protections to staff who report to or cooperate with the protection and advocacy system. (7) Adds a framework for the confidentiality of incident reports and investigation records while authorizing the Division to publish aggregate, de-identified information regarding incidents and trends across the behavioral health system. (8) Adds an injunctive relief pathway allowing the Department to seek a temporary restraining order in the Court of Chancery when a provider organization's activities create an imminent risk of substantial harm to clients. (9) Updates language throughout to reflect current person-centered terminology consistent with the preferences of the disability community. (10) Makes technical and conforming changes for clarity and consistency. This Act requires a greater than majority vote for passage because § 28 of Article IV of the Delaware Constitution requires the affirmative vote of two-thirds of the members elected to each house of the General Assembly to create a new crime within the jurisdiction of any inferior court of this State.
Approximately one in five adults report experiencing a mental health condition. At the same time, many individuals continue to face delays or barriers when trying to access care, even when they have insurance coverage. Delays, denials, or truncation of treatment leave families and their doctors battling for coverage instead of focusing on treatment and recovery. Families must pay out of pocket for care, on top of premiums for coverage they are not receiving. Further, Delawareans are five times more likely to go out-of-network for mental health care than for primary care, resulting in higher costs. This Act, known as the Fair Standards in Mental Health Care Act, builds on previous work to advance mental health parity and aims to ensure patients with private insurance can access timely, evidence-based mental health and substance use disorder care in Delaware. This Act supports improved access to mental health disorder and substance use disorder treatment by: 1. Adding and refining key terms, including definitions of mental health disorders and substance use disorders, level of care criteria, medically necessary treatment, utilization review and utilization review criteria to ensure consistency with widely accepted clinical standards of treatment and service intensity determination. This bill forges gold-standard clinical guidelines through requiring insurers to use transparent, evidence-based standards from independent experts, including the American Academy of Child and Adolescent Psychiatry. 2. Requiring coverage for all medically necessary treatment, including emergency services and all clinically appropriate levels of care. This bill ends prior authorization delays for mental health and guarantees emergency mental health coverage, just as Delaware already does for addiction treatment. 3. Requiring at least one formulation of certain FDA-approved medications to treat substance use disorders to be placed on the lowest-cost tier of drug formularies. 4. Prohibiting discrimination against individuals with current or predicted mental health disorders or substance use disorders. 5. Requiring carriers to arrange coverage of medically necessary out-of-network services without additional cost to the enrollee if in-network options are unavailable within applicable network access standards, thus ensuring real network access. 6. Removing language currently in the code barring a private right of action for violations of 18 Del. Code § 3343. In addition, the Act clarifies that carriers must provide nonquantitative treatment limitation parity analysis (NQTL parity analysis) that they are required to have completed under federal law to health care providers and current and prospective covered persons, free of charge, upon request. This Act applies to individual health insurance policies under Chapter 33 of Title 18 and group and blanket health insurance policies under Chapter 35 of Title 18. This Act applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2027. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
This Act amends the Childhood Lead Poisoning Prevention Act to update the statutory definition of confirmatory blood lead testing for children under 16 years of age. The Act allows a confirmed elevated blood lead level to be established either through a venous blood lead test or through two capillary blood lead screenings collected within 12 weeks of each other, provided that the applicable lead reference value is met or exceeded. Two positive capillary blood lead screenings yield an effective specificity of approximately 99.75% when properly collected. This change is consistent with the Centers for Disease Control and Prevention surveillance case definition, reduces barriers to case identification and management, and requires conforming regulatory updates.
In Delaware, all individual health insurance policies, all group and blanket health insurance policies, the State employee health insurance plan, and Medicaid are required to cover chiropractic and physical therapy treatment for chronic back pain without annual or lifetime numerical limits on physical therapy or chiropractic care visits. To evaluate the effectiveness of this coverage requirement, the Patient Centered Care Subcommittee of the Addiction Action Committee, under the Delaware Department of Health and Social Services, sent a survey to chiropractic therapy and physical therapy providers in Delaware. Although the survey showed that the coverage requirement has improved treatment of chronic pain patients, the survey also showed that the coverage requirement provides supportive chronic pain treatment for only the thoracic region of the spine, which is the middle of the spine from the base of the neck to the bottom of the ribs, and the lumbar region of the spine, which is the lower back. The treatment of chronic pain through chiropractic supportive care, physical therapy, or both, can prevent a patient from requiring opioid pain medications or more expensive treatments, but excluding vital areas of the spine and body from coverage may limit the effectiveness of chiropractic therapy and physical therapy treatment and limits a chronic pain patient’s potential for improvement. This Act encourages treatment of chronic pain patients without opioids by updating the required health insurance coverage to prohibit annual or lifetime numerical visits on physical therapy or chiropractic care visits that are for the purpose of treating the spine and other neuromusculoskeletal structures, including extremities. The updated coverage required under this Act applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2026. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
Excess skin and subcutaneous tissue can create a risk of rashes or infections, make walking and movement difficult, and make everyday chores difficult. An example of treatment that removes excess skin and subcutaneous tissue is a panniculectomy. A panniculectomy is an operative procedure that contours, or changes the shape and form, of the abdomen by removing significant excess skin and subcutaneous tissue. Removal of excess skin and subcutaneous tissue can improve a patient’s health and quality of life. This Act requires individual health insurance plans delivered under Chapter 33 of Title 18 and group and blanket health insurance plans delivered under Chapter 35 of Title 18 to cover medically necessary removal of excess skin and subcutaneous tissue, including panniculectomies. This Act also requires the State employee health insurance plan and State Medicaid plans to cover medically necessary removal of excess skin and subcutaneous tissue, including panniculectomies. Medically necessary means as defined in § 3371(8) for individual health insurance plans and as defined in § 3581(8) for group and blanket health insurance plans, State employee health insurance plans, and State Medicaid plans. This Act applies to all policies, contracts, or certicates issued, renewed, modified, alterered, amended, or resissued after December 31, 2026.
