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HB435 • 2025

AN ACT TO AMEND TITLES 18, 29, AND 31 OF THE DELAWARE CODE RELATING TO CERTIFIED REGISTERED NURSE ANESTHETISTS.

AN ACT TO AMEND TITLES 18, 29, AND 31 OF THE DELAWARE CODE RELATING TO CERTIFIED REGISTERED NURSE ANESTHETISTS.

Children Healthcare Labor
Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Minor-Brown
Last action
2026-06-30
Official status
Passed 6/30/26
Effective date
Not listed

Plain English Breakdown

The official source does not specify an immediate 'effective date' for the law itself, only when it applies to specific insurance policies.

Equal Payment for Nurse Anesthetists

This law stops Delaware health plans from paying Certified Registered Nurse Anesthetists less than physicians for the same services.

What This Bill Does

  • Requires individual, group, state employee, and Medicaid health plans to pay nurse anesthetists at least as much as they pay doctors for the same service.
  • Updates Titles 18, 29, and 31 of the Delaware Code with these payment rules.
  • Allows insurers to set different rates if those differences are based on quality or performance measures instead of who performed the service.

Who It Names or Affects

  • Certified Registered Nurse Anesthetists licensed in Delaware
  • Health insurers and carriers operating in the state

Terms To Know

Reimbursement rate
The amount of money a health plan pays to a provider for a specific medical service.
Certified Registered Nurse Anesthetist (CRNA)
A nurse who is specially trained and licensed to provide anesthesia care during surgeries or other procedures.

Limits and Unknowns

  • The law only applies to insurance policies issued, renewed, modified, altered, amended, or reissued after December 31, 2026.
  • Insurers may still pay different amounts if the difference is based on quality scores or performance data.

Bill History

  1. 2026-06-30 Delaware General Assembly

    Passed By Senate. Votes: 20 YES 1 ABSENT

  2. 2026-06-25 Delaware General Assembly

    Reported Out of Committee (Finance) in Senate with 4 On Its Merits

  3. 2026-06-24 Delaware General Assembly

    Reported Out of Committee (Banking, Business, Insurance & Technology) in Senate with 6 On Its Merits

  4. 2026-06-24 Delaware General Assembly

    Assigned to Finance Committee in Senate

  5. 2026-06-18 Delaware General Assembly

    Passed By House. Votes: 41 YES

  6. 2026-06-18 Delaware General Assembly

    Assigned to Banking, Business, Insurance & Technology Committee in Senate

  7. 2026-06-16 Delaware General Assembly

    Reported Out of Committee (Appropriations) in House with 5 On Its Merits

  8. 2026-06-16 Delaware General Assembly

    Reported Out of Committee (Appropriations) in House with 5 On Its Merits

  9. 2026-06-10 Delaware General Assembly

    Assigned to Appropriations Committee in House

  10. 2026-06-09 Delaware General Assembly

    Reported Out of Committee (Economic Development/Banking/Insurance & Commerce) in House with 2 Favorable, 7 On Its Merits

  11. 2026-05-21 Delaware General Assembly

    Introduced and Assigned to Economic Development/Banking/Insurance & Commerce Committee in House

Official Summary Text

AN ACT TO AMEND TITLES 18, 29, AND 31 OF THE DELAWARE CODE RELATING TO CERTIFIED REGISTERED NURSE ANESTHETISTS.
This Act prohibits individual, group, state employee, and Medicaid health plans from differentiating in the reimbursement rate of a health service based on whether the service was provided by a certified registered nurse anesthetist or by a physician.

Current Bill Text

Read the full stored bill text
Legislation Document

SPONSOR:

Rep. Minor-Brown & Sen. Poore

Reps. Gorman, Berry, Lambert, Snyder-Hall, Harris; Sen. Wilson

HOUSE OF REPRESENTATIVES

153rd GENERAL ASSEMBLY

HOUSE BILL NO. 435

AN ACT TO AMEND TITLES 18, 29, AND 31 OF THE DELAWARE CODE RELATING TO CERTIFIED REGISTERED NURSE ANESTHETISTS.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend Chapter 23, Title 18 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

§ 2318. Care by advanced practice

nurses.

nurses; certified registered nurse anesthetists.

(a)

No health insurer, health service corporation or health maintenance organization shall deny benefits for eligible services when the services are rendered or performed by an advanced practice

registered

nurse as long as

said

the

advanced practice

registered

nurse acts within the scope of practice

and/or definitions

pursuant to Title 24. Any contract of insurance issued or issued for delivery in this State by health insurers, health service corporations or health maintenance organizations shall not exclude advanced practice

registered

nurses as providers of services covered in the contract.

(b) All health insurance policies, contracts, or certificates that are delivered, issued for delivery, renewed, extended, or modified in this State and that provide coverage for a health service that a certified registered nurse anesthetist is licensed to perform under Title 24 shall provide for reimbursement of the service provided by the certified registered nurse anesthetist at a reimbursement rate that is not less than the reimbursement rate paid to licensed physicians providing the same service.

(c) Nothing in this section shall be construed to prohibit a health insurer, health service corporation, or health maintenance organization from establishing variable reimbursement rates based on quality or performance measures.

Section 2. Amend Chapter 52, Title 29 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

§ 5224. Certified registered nurse anesthetists.

(a) If the plan provides coverage for a health service that a certified registered nurse anesthetist is licensed to perform under Title 24, the reimbursement rate for the service provided by the certified registered nurse anesthetist may not be less than the reimbursement rate paid to licensed physicians providing the same service.

(b) Nothing in this section shall be construed to prohibit the plan from establishing variable reimbursement rates based on quality or performance measures.

Section 3. Amend Chapter 5, Title 31 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

§ 539. Certified registered nurse anesthetists.

(a) Carriers that provide coverage for a health service that a certified registered nurse anesthetist is licensed to perform under Title 24 shall provide reimbursement for the service provided by the certified registered nurse anesthetist at a reimbursement rate that is not less than the reimbursement rate paid to licensed physicians providing the same service.

(b) Nothing in this section shall be construed to prohibit a carrier from establishing variable reimbursement rates based on quality or performance measures.

Section 4. This Act applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2026.

SYNOPSIS

This Act prohibits individual, group, state employee, and Medicaid health plans from differentiating in the reimbursement rate of a health service based on whether the service was provided by a certified registered nurse anesthetist or by a physician.