Overview
STATE BUDGET
Delaware operates on an annual budget cycle. The governor submits a proposed budget by February 1 to the state legislature, and a budget is passed by June 30. The fiscal year begins on July 1 and ends on June 30 the following year.
STATE LEGISLATURE
The Delaware Senate has 21 members elected to four-year terms, and the House of Representatives has 41 representatives with two-year terms. The 61 seat assembly is the second smallest bicameral state legislature, ahead of only Alaska (60 members). The legislature convenes on the second Tuesday of January and sessions are required to adjourn by the last day of June. Legislation carries over from odd to even numbered years.
KEY RESOURCES
- Delaware State Legislature
- Delaware Office of the Attorney General
- Delaware Governor
- Delaware Health Care Claims Database
2025 LEGISLATIVE SUMMARY
Delaware passed HB212, which reduces the time period in which health insurers may initiate overpayment recovery efforts, and imposes evidentiary requirements on recovery based on fraud or abuse. It also heightens evidentiary requirements and imposes written notice of pharmacy audits for Pharmacy Benefit Managers.
Delaware Laws
Del. Code tit. 16, §§ 9902 through 9904A: Delaware Health Care Commission – Delaware
Introduced: Status: Enacted
Establishes the Delaware Health Care Commission as an independent state body that is charged with advising the Governor and General Assembly on healthcare policy. Its role is to “analyze all aspects of the health-care landscape, […]
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Del. Code tit. 18, § 102. Definitions: Delaware Insurance Code – Delaware
Introduced: Status: Enacted
“Balance billing” means a health-care provider’s demand that a patient pay a greater amount for a given service than the amount the individual’s insurer, managed care organization or health service corporation has paid or will […]
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Del. Code tit. 18, § 2318. Care by advanced practice nurses: Unfair Trade Practices Act – Delaware
Introduced: Status: Enacted
Statute prevents health insurers from denying benefits for eligible services when they are performed by an advance practice nurse acting within the scope of practice.
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Del. Code tit. 18, § 2501 through 2534: Rates and Rating Organizations – Delaware
Introduced: Status: Enacted
Requires that health insurers must file and obtain prior approval from the state department of insurance to implement premium rates, which are the costs of insurance broken down to a per-unit cost. Rates shall not […]
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Del. Code tit. 18, § 2730. Collection of overpayments by health insurers and health plans: Insurance Contracts Generally – Delaware
Introduced: Status: Enacted
A health insurer or health plan, whenever it engages in overpayment recovery efforts, shall provide written notice to the healthcare provider that identifies the error made in the processing or payment of the claim and […]
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