148th General Assembly
House Bill 166

Primary Sponsor(s): B. Short Additional Sponsor(s):    Sen. Blevins

Co-Sponsors: Reps. Briggs King, Mulrooney, Osienski; Sens. Ennis, Hocker

Introduced On:06/09/2015


Synopsis of Original Bill:
(without Amendments)
The purpose of this bill is to allow injured workers who seek medical care from out-of-state, non-certified health care providers, in the payment of their medical expenses. This revision will correct a flaw in the current statute that was exposed by the Delaware Supreme Court in the case of Wyatt v. Rescare Home Care, 81 A. 3d 1253 (Del. 2013) and Vanvliet v. D&B Transportation, 105 A.3d 390 (Del. 2014.). This bill removes the certification requirement for health care providers who are not licensed in Delaware, but licensed in another state; changes the allowable payment for these non-certified, out-of-state providers to the lesser of the usual and customary, the other state’s maximum reimbursement, Delaware’s maximum reimbursement, or a negotiated contract; and adds utilization review as a payer recourse for non-certified, out-of-state providers. This bill also allows the Workers’ Compensation Oversight Panel to realize the 2016 and 2017 mandated medical cost savings in the Delaware workers’ compensation system through any component of the health care payment system and not just the fee schedule. This bill also allows the Workers’ Compensation Oversight Panel to create regulations pertaining to the use of electronic billing in the workers’ compensation healthcare payment system.

Current Status:Signed   On  07/27/2015

Date Governor Acted: 07/27/2015 Effective Date:

Volume Chapter:80:124

Full Text of Legislation:
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Fiscal Notes/Fee Impact:Not Required


Substituted Legislation for Bill :

Committee Reports:House Committee Report 06/10/15 F=0 M=8 U=0---->Committee Report
Senate Committee report 06/24/15 F=2 M=3 U=0----->Committee Report

Voting Reports:House vote: () Passed 6/18/2015 6:03:37 PM------->Voting Record
Senate vote: () Passed 7/1/2015 12:05:59 AM------->Voting Record

Fiscal Notes/Fee Impact:

Engrossed Version:

Actions History:Jul 27, 2015 - Signed by Governor
Jul 01, 2015 - Passed by Senate. Votes: Passed 21 YES 0 NO 0 NOT VOTING 0 ABSENT 0 VACANT
Jun 24, 2015 - Reported Out of Committee (INSURANCE & TELECOMMUNICATIONS) in Senate with 2 Favorable, 3 On Its Merits
Jun 18, 2015 - Assigned to Insurance & Telecommunications Committee in Senate
Jun 18, 2015 - Passed by House of Representatives. Votes: Passed 39 YES 0 NO 0 NOT VOTING 2 ABSENT 0 VACANT
Jun 10, 2015 - Reported Out of Committee (ECONOMIC DEVELOPMENT/BANKING/INSURANCE/COMMERCE) in House with 8 On Its Merits
Jun 09, 2015 - Introduced and Assigned to Economic Development/Banking/Insurance/Commerce Committee in House