Healthcare (Medicare)

This Act provides that health care facilities must permit patients who have been issued and possess a valid registry identification card for the medical use of marijuana and have a terminal illness to use medical marijuana on the health care facilities’ premises, subject to certain restrictions. However, a health care facility may prohibit or suspend such use of medical marijuana under some circumstances, such as if the facility's medical professionals determine that use of medical marijuana may have an adverse impact on the medical care and treatment of the patient or is otherwise contraindicated, or if a federal regulatory agency, the United States Department of Justice, or the Centers for Medicare and Medicaid Services initiates an enforcement action against a health care facility based on the use of medical marijuana on the facility's premises or issues a rule or guidance prohibiting the use of medical marijuana at health care facilities. In addition, the Act provides that a person is not subject to civil or criminal liability or professional discipline for complying with the Act, except in cases of gross negligence, recklessness, or intentional misconduct. This Act is modeled on a 2021 California law known as "Ryan's Law."

This Act requires the Department of Health and Social Services to submit a Medicaid State Plan Amendment to the Centers for Medicare & Medicaid Services to be allowed to provide comprehensive dental benefits to Medicaid-eligible adults.

This Act provides a one-time increase of 3% in aggregate worker’s compensation medical expenses to correct reimbursements for medical services coded as evaluation and management (E&M) for worker compensation cases. This is needed as the E&M reimbursement rate for Workers’ Compensation cases has fallen below the reimbursement rate of the Center for Medicare & Medicaid Services rates. This is a critical need as the State of Delaware is in critical need of physicians to accept and treat worker compensation patients.

This Act creates a special open enrollment period for persons who are already enrolled in a Medicare supplement policy or certificate to cancel their existing policy or certificate and purchase another Medicare supplement policy or certificate that provides the same or lesser benefits. Only persons who are already enrolled in a Medicare supplement policy or certificate are eligible for the special open enrollment period. The special enrollment period begins 30 days before an eligible person's birthday and remains open for at least 30 days following the eligible person's birthday. During this special open enrollment period, individuals switching from one Medicare supplement policy to another cannot be denied coverage and coverage and rates cannot be dependent upon the person’s medical history. The Act also obligates issuers to notify eligible persons who are enrolled in their Medicare supplement policies or certificates of the dates of the open enrollment period, at least 30 days before it begins, and of any modification to the benefits provided by the policy under which the person is currently insured. This Act also allows persons enrolled in a Medicare Advantage plan to cancel their existing policy, enroll in Medicare during the annual Medicare open enrollment period and apply for a Medicare supplement policy. For individuals switching from Medicare Advantage to a Medicare supplement policy, the Act prohibits issuers of Medicare supplement policies from denying applications for such policies but does allow issuers to individually rate and apply a pre-existing condition limitation.

This is a Substitute for Senate Joint Resolution No. 7. Like Senate Joint Resolution No. 7, this Substitute directs the State Employees Benefits Committee (SEBC) to utilize specific strategies and policies when interacting and contracting with Pharmacy Benefit Managers (PBM) in order to achieve lower cost pharmaceutical drug benefit plans for the State. This Substitute differs from Senate Joint Resolution No. 7 by clarifying that the SEBC has a duty to consider all of the following strategies and policies when negotiating for pharmaceuticals: 1. Drug cost transparency. 2. Formation of an independent Pharmacy and Therapeutics Committee. 3. Any other supply chain tactics such as a reverse auction or transparency committee. 4. Compacts with other states to negotiate directly with drug manufacturers. 5. Paying no higher price for all drugs negotiated by Medicare. 6. Requiring PBMs disclose administrative expenses for all pharmaceutical drugs. 7. Requiring PBMs bid based on lowest pricing sources, not average wholesale price. 8. Requiring the SEBC be provided all agreements between PBMs and pharmaceutical companies when those agreements are for drugs contracted for on behalf of the SEBC. 9. Performing audits when the SEBC believes it should be entitled to information to achieve transparency or clarity. This Substitute differs from Senate Joint Resolution No. 7 by directing the SEBC to prepare a report by August 1, 2026, to summarize any difficulties in implementing any of these policies and to submit the report to the Governor; the President Pro Tempore of the Senate and Speaker of the House of Representatives, for distribution to all members of the General Assembly; the Director and the Librarian of the Division of Legislative Services; and the Public Archives.