Delaware General Assembly

Signed 7/13/16

The General Assembly has ended, the current status is the final status.

5/12/16

Baumbach

Sen. Henry

Reps. Bentz, J. Johnson, Q. Johnson, Kowalko, Mitchell, Paradee, Ramone, Smyk, Spiegelman, Viola, K. Williams
Sen. Hall-Long, Lopez, Sokola

AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO PRE-AUTHORIZATION.

Patients struggle every day to receive necessary care, suffering symptoms longer than appropriate and encountering unnecessary stress factors as they engage in the complicated system of health insurance. One such factor is Pre-Authorization, a tool designed to save the money by making sure that care is necessary. For years patients and clinicians have been put through arduous appeals processes being told that they are necessary to keep costs down or worse, told after the fact that their care won’t be paid for even when previously told otherwise. Yet, anecdotally, appeals to these decisions are nearly always granted after hours of staff and clinician time. Reliable data is difficult, if not impossible, to come by to evaluate if programs are worth the costs of time that they shift to the patient and clinician. This legislation requires greater transparency, efficiency, and fairness in pre-authorization programs.

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Takes effect upon being signed into law

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