This Act strengthens procedural protections for pharmacies, pharmacists, and consumers related to regulation of a pharmacy benefits manager by doing all of the following: Adds definitions for the terms “chronic or long-term condition”, “net amount”, “purchaser”, “recoupment”, “similarly situated contracted pharmacy”, and “wholesale invoice audit.” Applies audit notice requirements uniformly and ensures access to an appropriate point of contact. Requires a pharmacy benefits manager to provide a list of records that the auditing entity seeks to audit at least 5 business days before an audit. Limits activities to once every 12 months and sets standards for wholesale invoice audits. Ensures audit costs are borne solely by the pharmacy benefits manager. Clarifies that a pharmacy can appeal the amount of any reimbursement and that a contracted pharmacy’s representative can take actions and receive notices related to appeals on behalf of a pharmacy. Extends pharmacies’ ability to appeal from 10 days to 40 days to account for entities that complete retroactive billing. When an appeal is denied, requires the parties to provide a detailed reason for the denial and specific information about how the pharmacy can appeal the denial to the Department of Insurance. Prohibits retaliation by a pharmacy benefits manager when a pharmacist or pharmacy discloses information to a government agency or during a proceeding if the person who disclosed the information had reasonable cause to believe that the disclosed information is evidence of a violation of a state or federal law. Requires that a pharmacy benefits manager must provide at least 60 days’ notice before amending a contract with a pharmacy or pharmacist. Clarifies that the prohibition against spread pricing applies to all purchasers contracting with pharmacy benefits managers. Changes the reporting requirements for rebates so that pharmacy benefits managers must file the required reports annually instead of quarterly. This change will reduce the amount of incorrect or unclear reporting because rebates are aggregated and reported at the end of the period of time under each contract. Amends national drug acquisition cost compliance to refer to the date of service. Prohibits pharmacy benefit managers from unit-of-use requirements inconsistent with smallest package size availability and manufacturer recommendations. Requires that pharmacy benefit managers may not require pharmacies to dispense therapeutically equivalent or alternative drugs that cost the enrollee more out of pocket than the prescribed drug except for medical reasons. Ensures that enrollee-identifiable or prescriber-identifiable information is not transferred to or shared with affiliated pharmacies for any commercial purpose other than those defined. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
Senate Substitute No. 1 for Senate Bill 208 differs from Senate Bill No. 208 in the following 9 ways: 1. Makes technical corrections, including changing § 3508A and § 3509A to § 3508B and § 3509B to avoid confusion with existing code sections in Chapter 35A of Title 24 of the Code, correcting the title for § 3509 and § 3509B, and making changes to use consistent language and structure. 2. Adds cognitive rehabilitation to the list of evidence-based therapeutic interventions under the practice of psychology. 3. Adds cognitive therapy to the list of therapies that are included as examples of evidence-based interventions. 4. Replaces "organic brain syndromes" with the modern term " brain-based disorders". 5. Adds programs accredited by the Canadian Psychological Association to the list of degree programs that are accepted by the Board of Examiners of Psychologists (Board) for licensure or registration under Chapter 35 of Title 24 of the Code. This makes it easier for individuals from Canada to be licensed or registered under Chapter 35 of Title 24 of the Code. 6. Removes from the qualifications of applicants for licensure as a licensed psychology associate the requirement that a master’s degree must be from a program with a minimum of 60 graduate semester hours, because the qualifications of applicants for licensure as a psychologist do not include a required number of semester hours for doctoral degree programs. The Board determines the qualifications of applicants, including whether the applicant’s degree is from a program that meets the requirements listed in § 3508 and § 3508B of Title 24. 7. In the scope of practice of a licensed psychology associate, replaces "general measures of cognitive abilities and achievement" with "measures of intellectual ability". This clarifies that a licensed psychology associate may not administer neuropsychological tests. 8. Updates registration as a doctoral-level psychological assistant under § 3509 and registration as a master's-level psychological assistant under § 3509B to reflect modern practice. The applicant for registration, not the supervising psychologist or supervising licensed psychology associate, is responsible for providing to the Board evidence of the applicant's qualifications for registration. Similar updates are made throughout Chapter 35 of Title 24 to reflect that the individual applying for registration is applying rather than the supervising psychologist or licensed psychology associate. 9. Removes the requirement for applicants for licensure or registrations under Chapter 35 of Title 24 to submit the applicant’s criminal history reports from the State Bureau of Identification (SBI) and the Federal Bureau of Investigation (FBI) to the Board. The Board directly receives electronic copies of each applicant’s criminal history reports from the SBI and the FBI, as provided in § 3508(b)(1), § 3508B(b)(1), §3509(b)(1), and §3509B(b)(1). Like SB 208, this Act adds 2 additional psychology professionals regulated under Chapter 35 of Title 24: (1) a licensed psychology associate and (2) a master’s-level psychological assistant. This Act also renames the psychological assistant registered under § 3509 of Title 24 to “doctoral-level psychological assistant” to mark the difference in education between the existing psychological assistant and the master’s-level psychological assistant added by this Act. This Act also changes § 3511 to clarify that licensing through reciprocity does not apply to individuals registered under § 3509 and § 3509B. A licensed psychology associate may independently practice at a master’s-level of education and training, subject to the limitations listed under § 3508B(e) added by this Act. The Board of Examiners of Psychologists (Board) may grant a license to practice as a licensed psychology associate if an applicant meets certain qualifications, including holding a master’s degree in psychology from an accredited school, completing an internship, obtaining at least 2 years of supervised professional experience, and achieving a passing score on a Board-approved examination. A licensed psychology associate is subject to the same standards as a psychologist licensed under Chapter 35 of Title 24, including handling of patient records, mandatory reporting, character and fitness requirements, and professional discipline. A licensed psychology associate also may be granted a license by reciprocity. An individual who is seeking further licensure under Chapter 35 of Title 24 may register as a master’s-level psychological assistant. A master’s-level psychological assistant may perform specific functions, appropriate for the assistant’s level of education and training, under the supervision of a licensed psychologist or licensed psychology associate. The supervising licensed psychologist or supervising licensed psychology associate may apply to the Board for registration of a master’s-level psychological assistant and shall provide to the Board evidence that the individual presented for registration has the required master’s-level of education and training, that the individual will receive appropriate training and supervision, that the individual meets character and fitness requirements. The supervising psychologist or licensed psychology associate must also give the Board a statement outlining the specific functions the master’s-level psychological assistant will perform under supervision. The individual seeking registration must provide a statement, under oath, that the individual will not practice independently, will perform only the specific functions outlined in the statement submitted by the supervising psychologist or supervising licensed psychology associate, and will not represent that the individual is a licensed psychologist or licensed psychology associate. A master’s-level psychological assistant is subject to the same professional standards and professional discipline as a doctoral-level psychological assistant. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual. Technical changes include removing deadlines that have passed and are no longer relevant, changing language to increase clarity and consistency, and changing the structure of certain paragraphs to increase readability and organization. Additionally, to clarify that all applicants for licensure or registration under Chapter 35 of Title 24 must provide criminal background checks, this Act moves the provision requiring applicants to provide fingerprints to obtain a criminal background report from § 3514 of Title 24 to the qualification requirements for each individual licensee or registrant under § 3508, § 3508B, § 3509, and § 3509B of Title 24. This Act requires a greater than majority vote for passage because § 11 of Article VIII of the Delaware Constitution requires the affirmative vote of three-fifths of the members elected to each house of the General Assembly to impose or levy a tax or license fee. This Act is effective on its enactment and is to be implemented the earlier of the following: 1. Twelve months from the date of enactment. 2. Notice by the Board of Examiners of Psychology published in the Register of Regulations that final regulations to implement this Act have been adopted.
The Health Care Professional Access Act requires carriers to participate in uniform processes with specific timetables to create speed-to-market for health care professionals. Currently, health care professionals may be employed for 6 months or more with no ability to collect insurer reimbursement due to lengthy carrier credentialing process. Ensuring uniformity across carriers, as well as relevant procedural standards, will help attract and retain health care professionals in our state, enable movement between practices and the creation of new ones, and ensure nondiscrimination in credentialing decisions. Under this Act, credentialing processes are limited to 45 days. This Act additionally provides for provisional credentialing, whereby reimbursement ability is provided even more quickly for certain health care professionals, including FQHCs, and in designated shortage areas which currently include mental health professionals statewide and primary and dental care in Kent and Sussex Counties, or is offered if timelines are not met. Oversight of compliance with this Act falls to the applicable regulatory agency. The Act also ensures specific processes and health care professional rights during a carrier’s intent to terminate a credential. More than 30 states have credentialing standards in law, with additional jurisdictions considering relevant legislation. Components of this legislation are derived from the National Association of Insurance Commissioners’ Health Care Professional Credentialing Verification Model Act. This substitute differs from the original in that it does the following: - Clarifies that it applies to those carriers that require credentialing and does not require carriers to create a credentialing process if they do not already do so; - Clarifies the process for credentialing of health care professionals whose primary or home state is not Delaware and prefer to use the credentialing process in their primary or home state; - Allows a carrier to require earlier recredentialing to address activity that could disqualify a health care professional from credentialing; - Allows for certain electronic delivery of recredentialing notices; - Simplifies the language for the basis to deny, suspend, nonrenew, or terminate a health care professional’s to align with NCQA standards; - Clarifies that the penalties and remedies in this Act are in addition to those already otherwise available; and - Makes technical changes to information about CAQH.
This House Concurrent Resolution requests the Department of Labor to evaluate the feasibility of apprenticeship programs for school-based mental health professionals and submit a report to certain members of the General Assembly, the Office of Management and Budget, and the Controller General by November 1, 2026.
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.
This Act authorizes physician assistants, occupational therapists, and nurse practitioners to practice dry needling. This Act sets forth requirements and limitations pertaining to the practice of dry needling. Dry needling may not be performed without a physician referral, and physician assistants, nurse practitioners, and occupational therapists may not hold themselves out as acupuncturists unless they are licensed acupuncturists.
This Act requires that effective amounts of folic acid be added to corn masa flour and corn masa which are staples in many minority diets. Under this Act, corn masa flour sold or used in the State must contain folic acid at a level of .7 mg of folic acid per pound of corn masa flour. Wet corn masa product must contain .4 mg of folic acid per pound of end product. These products must include a declaration of folic acid on the nutrition label in accordance with applicable federal law. Minority communities in the United States face a greater risk of neural tube defects (NTDs), which are serious birth defects that occur during early pregnancy. NTDs include spina bifida, characterized by an opening along the spine that can cause mild to severe nerve damage and disability, and anencephaly, a fatal condition where parts of the brain or skull are missing in newborns. Research has shown that daily intake of folic acid can reduce the risk of NTDs by over half. In response, the U.S. Food and Drug Administration mandated folic acid fortification in enriched cereal grain products in 1998, resulting in a 35% reduction in NTD cases. However, this policy did not include corn masa flour, a staple in many minority diets.
The Department of Health and Social Services (DHSS), through the Division of Services for Aging and Adults with Physical Disabilities (DSAAPD), operates the Delaware Hospital for the Chronically Ill (DHCI), a Long-Term Care (LTC) facility in Smyrna, Delaware. DHCI is a facility of last resort for Delawareans that require a skilled nursing facility level of care and have no viable options for private nursing facility care. The Delaware Hospital for the Chronically Ill’s name no longer reflects the dignity of all residents who live there. The existing statute uses outdated and offensive language, often referring to residents as “inmates.” It does not align with current policies and procedures around operation and maintenance of DHCI or the skilled care, screening, and admission of its residents, nor does it recognize DHCI’s role as a skilled nursing facility that maintains a five-star rating from the Centers for Medicare and Medicaid Services (CMS). This bill provides a technical update to reflect DHCI’s current practices, policies and procedures as a LTC facility of last resort. It strikes outdated language and aligns the statute with current DHCI, state, CMS practices and requirements. Finally, this bill renames the Delaware Hospital for the Chronically Ill to the Eleanor Cain Center. It will be named in honor of Eleanor Lee Cain, who served as the DSAAPD director from 1973 to 2001 and was a champion for older adults.
This Act amends Title 16 to establish statewide standards for levels of neonatal care for facilities that operate neonatal nurseries or neonatal intensive care units. The Act requires facilities to comply with nationally recognized standards for levels of neonatal care established by the American Academy of Pediatrics (AAP), ensuring that newborns receive care in facilities equipped to meet the complexity of their medical needs. Under the Act, the Secretary of the Department of Health and Social Services (DHSS) will designate each facility's level of neonatal care based on compliance with the AAP standards, including staffing, equipment, facility capabilities, and patient protocols. The Act further establishes additional requirements for facilities providing Level IV NICU services which care for the most critically ill and medically complex newborns. DHSS must adopt implementing rules by January 30, 2027, and will seek input from the Delaware Perinatal Quality Collaborative and existing NICU providers in developing these rules.
This House Substitute for House Bill No. 394 creates a process for which the Division of Public Health creates signage stating that energy drinks and caffeinated dietary supplements are not recommended for children, individuals sensitive to caffeine, pregnant women, or women who are nursing. Dealers of energy drinks and caffeinated dietary supplements are then required to display the sign in a publicly visible location next to the products.
