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.
This Act makes several changes to the Delaware Nursing Home Residents Quality Assurance Commission ("Commission"): - Modernizes the Commission name to the "Delaware Residents’ Protection Commission." The Joint Legislative Oversight and Sunset Committee, during its review of the Commission from 2020-2022, recommended the Commission change its name to something shorter that is easier to remember. - Better delineates the Commission's duties. - Adds provisions to streamline the Commission's operations, including removal of a member who consistently misses meetings and approving Commission action on the affirmative vote of a majority of members present at a meeting. - Gives the Commission the authority to seek grants to support the Commission's operations. - Allows for the establishment of subcommittees to more effectively and efficiently meet the needs of the Commission - Clarifies the Commission’s responsibility to advocate for residents of monitored facilities, work with other agencies and groups to promote systemic reform, and act as an informational resource for the public. - Authorizes the Commission to hold a virtual meeting with a physical location open to the public if a Commission staff member is present at the anchor location. This Act has an effective date of 90 days after the date of enactment into law, to provide the Commission with time to transition from the existing membership to the membership that this Act establishes. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual. Like Senate Substitute No. 1 for Senate Bill No. 155, Senate Substitute No. 2 for Senate Bill No. 155 differs from Senate Bill No. 155 by doing the following: - Changes the term "long-term care facility" to "monitored facility." - Removes language relating to Administrative Office of the Courts. - Adds 2 members to the Commission: the President of LeadingAge New Jersey/Delaware and the Director of State Governor Affairs, Delaware, of the Alzheimer's Association, Delaware Valley Chapter. - Makes a technical change to the provision relating to virtual meetings. In addition, Senate Substitute No. 2 for Senate Bill No. 155 differs from Senate Bill No. 155 as follows: - Maintains the Gubernatorial appointments as they exist in current law. - Amends a Commission duty so that, under this Act, the Commission provides education and recommends policies aimed at improving the quality of care, quality of life, and safety of residents of monitored facilities.
This Act updates the Board of Dietetics/Nutrition enabling act, requiring applicants to obtain a minimum of a master’s degree to obtain a license. This change would make Delaware consistent with the Commission on Dietetic Registration (CDR), the credentialing agency of the American Dietetic Association. Beginning on January 1, 2024, CDR required a minimum of a master’s degree in order to become registered. Under the current law, holders of a CDR registration are considered to automatically meet the qualifications for licensure in Delaware, and applicants who are certified by the Board for Certification of Nutrition Specialists must also acquire a minimum of a master’s degree. This Act ensures Delaware is consistent with the current national standards for licensure and registration as a Dietitian or Nutritionist. Finally, the Act eliminates an outdated application provision. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
This Act clarifies the requirements regarding obtaining a permit to operate a funeral establishment. Technical corrections are also made to existing statutory language to conform with the requirements of the Legislative Drafting Manual.
This Act repeals the Hearing Aid Loan Bank Program, as the program is no longer operational. The Program was created pursuant to Volume 74, Chapter 109 of the Laws of Delaware (2003), for the purpose of lending hearing aids on a temporary basis to children under 3 years old. Loans were initially for 6 months with possible 3-month extensions granted by the Program Manager. The need for the Hearing Aid Loan Bank Program has steadily decreased over time and the Program is now obsolete. As a result, the Division of Public Health no longer stocks the Hearing Aid Loan Bank.
This Act expands the definition of the “practice of dental hygiene” under Title 24 (Professions and Occupations) to include the administration of local anesthesia under the direct supervision of a licensed dentist and directs the State Board of Dentistry and Dental Hygiene (“Board”) to establish the necessary requirements and standards. Currently, Delaware is the only state in the nation that does not allow dental hygienists to administer local anesthesia. Delaware also suffers from a shortage of dental care providers, leaving many Delawareans unable to access timely, quality, affordable dental care. Administering local anesthesia is a task that properly trained dental hygienists can do safely, as shown by the experiences of every other state. Expanding dental hygienists’ scope of practice to allow them to administer local anesthesia under the direct supervision of a licensed dentist will enable them to provide a broader range of services to patients and take some of the burden off the state’s limited supply of dentists. Section 4 of this Act requires the Board to adopt regulations setting the requirements and standards to allow dental hygienists to administer local anesthesia under direct supervision of a licensed dentist no later than January 1, 2026. Section 5 of this Act provides that Sections 1 through 3 of this Act are effective on either January 1, 2026, or when the State Board of Dentistry and Dental Hygiene publishes final regulations implementing the Act, whichever is earlier. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
The Public Health Emergency Planning Commission was established in 2002 and directed to deliver to the Governor a plan for responding to a public health emergency that addressed at least 21 specific provisions. Since then, that single plan has evolved into an overarching Public Health Emergency Operations Coordination Plan, which is a strategic plan that provides a broad context for the execution of public health emergency response and recovery. There are over 70 additional “plans” or annexes that provide additional procedural guidance that have been developed by DHSS in partnership with other state agencies and external stakeholders such as hospitals. The Public Health Emergency Operations Coordination Plan will still be updated every 2 years by DHSS and other state agency and private partners. The Public Health Emergency Planning Commission will be renamed the Public Health Emergency Planning Council. It will review the Public Health Emergency Operations Coordination Plan every 2 years. It will also continue in its advisory capacity to the Governor whenever a public health emergency is declared. It must meet within 30 days of the declaration of a state of emergency due to a public health emergency, and at least every 30 days until the public health emergency is lifted. In the absence of a public health emergency the Council must meet at least once a year. This Act also makes technical corrections to existing statutory language.
This Act updates Chapter 10A of Title 16, the Healthcare-Associated Infections Disclosure Act, to ensure consistency with correct terminology, such as psychiatric changes to behavioral health facilities and to adherence to Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) requirements. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
This Act enters Delaware into the Social Work Licensure Compact. This will allow social workers to obtain a multistate license among the member states. Delaware will join the Compact Commission that is comprised of membership of all states that have enacted the Compact. Enough states have enacted the Compact that the Commission has been created and the applications for licensure could start in late 2025. Currently, at least 24 states have joined the Compact, while another 18 have pending legislation to enact the Compact, including Maryland and Pennsylvania. This Substitute changes the Chapter and Section numbers to place the Chapter in a more appropriate place in the code, and it corrects internal references to the new section numbers.
This Act provides that privilege between a policyholder or claimant and an insurance company is not waived simply because information is submitted by companies to the Insurance Commissioner, whether or not the information is redacted.
This Act amends the provisions of Title 29 of the Delaware Code § 7915 relating to the Council for Services for Aging and Adults with Physical Disabilities. This Act adds a Conflict of Interest Policy to § 7915 to ensure compliance with the Older Americans Act Final Rule and must be enacted into law by October 1, 2025.
