Photo of Marie Pinkney
D Delaware Senate · District 13 On the 2026 ballot

Sen. Marie Pinkney

Compare
Total votes
2,845
all sessions
Attendance
98%
67 missed
Near the chamber average
With party
99%
of cast votes
Near the chamber average
Bipartisan score
0%
crosses aisle rarely
Near the chamber average
Sponsored
1,092
bills & resolutions
Near the chamber average
Committees
6
assignments
1,092 bills and resolutions

Sponsored bills

Total
1,092
Primary
889
Co-sponsor
203
This page
1,092
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Primary SB 220
Signed into law · Delaware Senate · Lead sponsor
AN ACT TO AMEND TITLE 18 RELATING TO HEALTH INSURANCE FOR CHILDREN AND PERSONS ON MEDICAID.

Medicaid is generally the “payer of last resort,” meaning that Medicaid only pays claims for covered items and services if there are no other liable third-party payers for the same items and services. When Medicaid beneficiaries have one or more additional sources of coverage for health care services, third-party liability (TPL) rules govern the legal obligation of such third parties. Section 1902(a)(25)(A) of the Social Security Act defines third-party payers as health insurers, managed care organizations, and group health plans, among others. The federal Consolidated Appropriations Act of 2022 (CAA 2022), enacted March 15, 2022, increased state flexibility with respect to TPL. Section 202 of the CAA, 2022 amended section 1902(a)(25)(I) of the Act to require a state plan for medical assistance to provide assurances satisfactory to the Secretary that the state has state laws in place that bar responsible third-party payers (other than Medicare plans) from refusing payment for an item or service solely on the basis that such item or service did not receive prior authorization under the third-party payer’s rules. Specifically, if the responsible third party requires prior authorization for an item or service furnished to a Medicaid-eligible individual, the responsible third party must accept the authorization provided by the state that the item or service is covered under the state plan (or waiver of such plan) for such individual, as if such authorization was made by the third party for such item or service. Authorization by the state means that the item or service an individual received (and for which third-party reimbursement is being sought) is a covered service or item under the Medicaid state plan (or waiver of such plan) for that individual. The effective date for this new federal provision is January 1, 2024, with an exception for states that first need to pass state legislation to comply with the change in law. This bill is intended to update the provisions of Title 18, § 4003 to make them consistent with federal law contained in the Consolidated Appropriations Act of 2022.

Signed into law Apr 30, 2024 0 co-sponsors
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