This Act adds optometrists as health care providers who are eligible for the Health Care Provider Loan Repayment Program and limits the number of health care loan provider repayment grants to 2 optometrists per year.
This Bill updates Title 11 of the Delaware Code relating to animal cruelty. After 2 misdemeanor violations of this section, currently class A misdemeanors, all further violations are to be upgraded to class F felonies. Also, after the first felony violation of the statute, currently a class F felony, which involves intentionally killing or causing serious injury to any animal in violation of the statute, all further violations are to be upgraded to class E felonies. Also, any person convicted of a felony violation a second time shall be prohibited from owning or possessing any animal for the remainder of their life without exception.
This Act is a Substitute for Senate Bill No. 13. Like Senate Bill No. 13, this Substitute Act amends Title 16 and Title 6 of the Delaware Code relating to hospital charity care and financial assistance and does the following: (1) Section 1 of the Act amends § 9311 of Title 16 to exempt certain hospitals from the existing charity care requirement and require these hospitals to comply with the new financial assistance requirements under Section 2 of this Act. A hospital that provides exclusively psychiatric services, rehabilitative services, or long-term acute care services remains subject to the charity care requirement. (2) Section 2 of the Act creates a new Subchapter VII of Chapter 99 of Title 16, §§ 9961 through 9966, establishing minimum financial assistance standards for hospitals and facility-based providers. The subchapter requires full financial assistance for Delaware residents with household income at or below 300% of the federal poverty level, a 75% discount above 300% and at or below 350%, and a 50% discount above 350% and at or below 400%, and requires each hospital to maintain a medical hardship policy providing a 50% minimum discount with an income ceiling of at least 500% of the federal poverty level. Eligibility determinations are valid for at least 1 year, transfer among hospitals and facility-based providers, and suspend collection activity while an application or appeal is pending. Hospitals must provide notice in languages spoken by more than 5% of the hospital's service area, screen patients for financial assistance, report annually to the Diamond State Hospital Cost Review Board (“Board”), and publish a financial assistance policy addressing presumptive eligibility, the application process, Medicaid coordination, and patient refunds. The Board administers the subchapter and conducts compliance reviews, the Division of Health Care Quality may take licensure action on a finding of noncompliance, and the obligations run with the hospital license. (3) Section 3 of the Act amends § 2505J of Title 6 to prohibit a medical creditor or medical debt collector from taking extraordinary collection action against a patient who qualifies, or whom the creditor has reason to know likely qualifies, for financial assistance. (4) Section 4 of the Act amends § 2508J of Title 6 to restrict collection communications, litigation, and debt referrals or sales by a medical creditor or medical debt collector that knows or should know that a patient’s financial assistance application or appeal is pending. (5) Section 5 of the Act amends § 2511J of Title 6 to make noncompliance with the new subchapter, or a patient’s eligibility for financial assistance, a complete defense in a civil action to collect medical debt, and to bar entry of a default judgment in any such action without an affidavit from a responsible officer of the hospital attesting that the patient was offered financial assistance screening. (6) Section 6 of the Act provides that the minimum financial assistance standards under § 9962(a) and (b) of Title 16 take effect on January 1, 2027, and that all other provisions take effect on the earlier of notice by the Diamond State Hospital Cost Review Board, published in the Register of Regulations, that final implementing regulations have been adopted, or July 1, 2027. This Substitute Act differs from Senate Bill No. 13 as follows: (1) Alphabetizes definitions in Section 2 of this Substitute Act and makes other technical corrections throughout this Substitute Act. (2) Clarifies that hospital services do not include services provided by a facility-based provider at a location that is not the hospital, an off-campus location operated under the hospital's license or Medicare provider agreement, or a freestanding emergency department affiliated with the hospital. (3) Makes clear that financial assistance is available to a patient for the patient responsibility portion. (4) Makes clear that a hospital or facility-based provider may bill a financially qualified patient’s insurance for hospital services. (5) Requires that a hospital that issues a written eligibility notice include with the notice supporting documentation provided by the patient. (6) Provides that written notice must be in print or electronic form, as determined by the patient. (7) Provides that a patient seeking financial assistance or medical hardship must apply for financial assistance. (8) Specifies that the Diamond State Hospital Cost Review Board must develop regulations related to the requirement that a recipient of financial assistance must be a Delaware resident. (9) Moves the Division of Health Care Quality’s power to impose civil monetary penalties for the violation of Subchapter VII of Chapter 99 of Title 16 into § 9965 of Title 16 (within Subchapter VII of Chapter 99 of Title 16) rather than adding it to § 1007 of Title 16. As a result, the amendment to § 1007 of Title 16 contained in Section 3 of Senate Bill No. 13 is removed from this Substitute Act. The Division’s power is the same power the Department of Health and Social Services has under Chapter 10 of Title 16.
This Act amends Titles 16, 18, 29, and 31 of the Delaware Code and Chapter 237, Volume 83 of the Laws of Delaware relating to primary care insurance. Among other things, the Act does the following: Section 1 of the Act amends § 9903 of Title 16 of the Delaware Code to provide that the Health Care Commission, in coordination with the Primary Care Reform Collaborative, will monitor compliance of primary care providers with value-based care delivery models established under the Office of Value-Based Health Care Delivery (OVBHCD). Section 2 of the Act amends § 9904A of Title 16 to remove a time frame limitation for the period during which the Health Care Commission is authorized to request written reports by health insurers regarding progress in adopting and implementing value-based payment models. Under the Act, the PCRC may continue to request such reporting going forward. Section 3 of the Act amends § 329 of Title 18 to provide that administrative penalties for violations of §2503(a)(12), §2503(a)(15), § 3342B, and § 3556A of Title 18 may be equivalent to the amount of the violation, and that penalties imposed for such violations are to be deposited into a Primary Care Fund, which will be used by the Statewide Benefits Office and the Division of Medicaid and Medical Assistance. Section 4 of the Act amends § 334 of Title 18 to clarify that the OVBHCD has the ability to promulgate regulations necessary to accomplish the stated goals of reducing health-care costs by increasing the availability of high quality, cost-efficient health insurance products that have stable, predictable, and affordable rates. Section 5 of the Act amends § 2503 of Title 18 to extend current cost containment calculations to rate filing year 2027. Given their relative size and patient populations within Delaware's health care market, Delaware's two smallest hospitals and lone free-standing children's hospital are exempt from that extension. In rate filing year 2028 and thereafter, the Act specifies that costs per service for health benefit plans may not exceed certain Medicare Reference-Based Pricing Targets, which are based on the “Full Medicare rate,” meaning the applicable wage-adjusted base Medicare rate for different services, the Free-Standing Children’s Hospital Medicare outpatient payment rate, or the TEFRA Rate, meaning the target amount under the federal Tax Equity and Fiscal Responsibility Act (TEFRA) Waiver Program applicable to Free-Standing Children's Hospitals, unless certain exemptions apply. Those exemptions are for Delaware's two smallest hospitals and, if making progress with value-based care, for a Delaware hospital in a high-growth, high-Medicare population region. Carriers issuing plans in the commercial market for 2 consecutive years and that cover more than 5,000 members must meet minimum percentages of alternative payment model contracting, as specified. Section 6 of the Act amends § 3342B of Title 18 concerning primary care coverage offered by individual insurance plans. Under the Act, starting in 2026, carriers must spend at least 11.5% of their total cost of medical care on primary care, at least 5% of which must be via prospective primary care management payments. Carriers must offer value-based care programs and may not deny contracted providers the opportunity to participate in an offered value-based care program. In addition, the Commissioner is required to issue regulations regarding the calculation of total cost of care. Section 7 of the Act applies the same changes as Section 6 of the Act to § 3556A of Title 18, concerning primary care coverage offered by group insurance plans. Section 8 of the Act deletes a sunsetting clause contained in Section 14, Chapter 237, Volume 83 of the Laws of Delaware, which would have repealed § 2503(a)(12)a., § 3442B(b)(3), and § 3556A(b)(3) of title 18, effective January 1, 2027. Section 9 of the Act amends § 5204 of Title 29 to provide that health-insurance coverage for public officers and employees shall be provided by a carrier whose cost per service may not exceed certain Medicare Reference-Based Pricing Targets, which are based on the Full Medicare rate, the Free-Standing Children's Hospital Medicare outpatient payment rate, or the TEFRA Rate, unless certain exemptions apply. Those exemptions are for Delaware's two smallest hospitals and, if making progress with value-based care, for a Delaware hospital in a high-growth, high-Medicare population region. In addition, Section 9 of the Act specifies that coverage shall be provided by a carrier offering value-based care programs equivalent to the commercial market requirements. Section 10 of the Act amends §5224 of Title 29 concerning primary care coverage of insurance coverage for public officers and employees, to require plans to report data to the OVBHCD on the percentage of primary care spending as a percentage of total medical costs for plan years 2027 and 2028 and to increase spending on primary care by 1% per year thereafter until primary care spending reaches 11.5% of total medical costs. Section 11 of the Act creates §539 of Title 31, concerning state public assistance, to require entities providing health insurance under § 505(3) to report data on the percentage of primary care spending as a percentage of total medical costs for 2 plan years and, in subsequent years, increase primary care spending by 1% until primary care spending reaches 11.5% of total medical costs. Section 12 of the Act provides that the Department of Insurance shall promulgate regulations pursuant to the Act within 18 months of enactment, but shall promulgate regulations on or before January 1, 2027 establishing a methodology to determine any appropriate annual inflationary or other applicable adjustments to a hospital's Full Medicare Rate. Like Senate Substitute No. 1 for Senate Bill No. 1, this Act differs from Senate Bill No. 1 in that it bases the limits for costs per service for health benefit plans on Medicare Reference-Based Pricing Targets, which may differ based on whether the services are outpatient services, inpatient hospital services, or emergency department services, and on whether the services are being provided by a Free-Standing Children's Hospital; under Senate Bill No. 1, the limits for cost-per-service were based on a percentage of Medicare reimbursement for comparable services. In addition, this Act provides more guidance regarding the application of exemptions from those limits. In addition, Senate Substitute No. 2 for Senate Bill No. 1 differs from Senate Bill No. 1 in that it makes technical edits to definitions and it provides that the Department of Insurance and the State Employee Benefits Office shall lead a process, in consultation with Delaware hospitals, to recommend an appropriate methodology to determine and apply any inflationary or other applicable adjustments to a hospital's Full Medicare Rate not otherwise captured in a hospital's annual Medicare rate update by January 1, 2027. Senate Substitute No. 2 for Senate Bill No. 1 also adds an exemption from the aggregate unit price growth limits in § 2503(a)(12)a.3. of Title 18 for a hospital that is a Free-Standing Children's Hospital, a hospital that qualifies as a Medicare-Dependent Rural Hospital on the grounds that it meets the definition of a Medicare-dependent hospital under 42 C.F.R. § 412.108 for at least 3 of the 5 years immediately preceding the applicable rate filing year, or an Urban Medicaid DSH Hospital.
This Act provides supplementary appropriations to certain Grants-in-Aid recipients for Fiscal Year 2027. Section 1 – Government Units and Senior Centers $40,534,269 Section 2 – One-Times and Community Agencies $42,346,157 Section 3 – Fire Companies and Public Service Ambulance Companies $15,541,500 Section 4 – Veterans Organizations $985,125 GRAND TOTAL $99,407,051
This bill builds on the customer protections created in Senate Bill 60 in 2025, as follows: 1. Increases transparency in rates and communications by public utilities. 2. Requires regular management audits of certain public utilities and regulatory accounting reviews with each rate case proceeding. 3. Provides greater consistency in the data used by public utilities in rate case proceedings. 4. Limits how much utilities can collect in interim rates before the Commission has ruled on a rate increase request. 5. Prohibits public utilities from recovering certain expenses from ratepayers. 6. Requires the Commission to provide rationale for its decisions in accepting settlement agreements. 7. Puts limits on Delmarva Power’s infrastructure spending, which is a major driver of rate increases. Delmarva Power is operating its electric distribution system at a level far in excess of reliability standards set by the Commission. In support of its parent company’s strategic goal to increase earnings by increasing rate base, Delmarva Power’s annual capital spending leads to frequent rate increase requests to the Commission. Part of Delmarva Power’s capital spending includes “non-mandatory projects,” which by definition are projects that are not required to maintain system reliability. This bill limits the amount of non-mandatory capital expenses the company may recover from ratepayers in rates and is indexed to the company’s rate base, i.e. the value of all its capital assets. Limiting non-mandatory cost recovery will in no way impact Delmarva Power’s ability to restore service after storms nor impact its vegetation management (tree trimming) program.
Maddy summaryThis bill establishes the official financial projections for the state's General Fund for Fiscal Year 2027. It sets specific estimates for expected revenue, refunds, and available unencumbered funds to guide future budget planning. The legislation applies to the state government by defining the financial baseline for the upcoming fiscal year. After passing both legislative chambers, the bill was signed into law by the Governor.
This Act removes from the Town of Cheswold certain parcels of real property within the Nobles Pond development that are currently within the territorial limits of the Town of Cheswold. This Act requires a greater than majority vote for passage because § 1 of Article IX of the Delaware Constitution requires the affirmative vote of two-thirds of the members elected to each house of the General Assembly to amend a municipal charter, whether directly, by amendment to a specific municipality’s charter, or indirectly, by a general law.
This Act requires large energy use facilities to produce renewable energy within the state to power their operations to prevent a drain on the electric grid. It provides for a “ramp-up” period requiring that a large energy use facility provide a plan to the Public Service Commission to ramp up their energy production within the state each year so that by the 10th year of operations, the facility is producing 100% of its energy usage through in-state production. This Act also allows the Public Service Commission to regulate electric suppliers insofar as necessary to ensure that large energy use facilities do not negatively affect the reliability of the electric grid.
This Act's purpose is to create checks and balances between the Executive and Legislative Branches of State government relating to Emergency Orders. This Act recognizes the authority of the Governor to act in the event of an emergency by allowing the Governor to declare an emergency for 120 days and to renew that order for up to 60 more days, for a total of 180 days. Thereafter, to extend or renew the emergency order beyond the 180 days, such order will be subject to actions taken by the General Assembly. The Governor may terminate any emergency order or renewal order at any time. This substitute bill clarifies that after an Emergency Order has been in effect for 180 days, the General Assembly may act to terminate or amend the Order, but the Order could continue to be renewed until the Governor or the General Assembly act to the contrary. Also, the substitute requires a report to the General Assembly every 30 days during the continuation of a State of Emergency.
