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Straight-ahead summaries built from the official bill text. We keep the source links front and center and leave the decision up to you.

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SA1TOSB6 • 2025

This Amendment clarifies that a health-care provider may determine that a covered health-care service delivered on an expedited basis is an “urgent health-care service.” In addition, this Amendment provides that any compensation paid to a health-care provider or consulting health-care provider for review of a clean pre-authorization request submitted by a health-care provider other than a physician, or of an appeal from an adverse determination of such a request, may not be contingent upon the outcome of the review.

This Amendment clarifies that a health-care provider may determine that a covered health-care service delivered on an expedited basis is an “urgent health-care service.” In addition, this Amendment provides that any compensation paid to a health-care provider or consulting health-care provider for review of a clean pre-authorization request submitted by a health-care provider other than a physician, or of an appeal from an adverse determination of such a request, may not be contingent upon the outcome of the review.

Passed Legislature

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

Sponsor
Last action
2025-05-14
Official status
Introduced and Placed With Bill
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

This Amendment clarifies that a health-care provider may determine that a covered health-care service delivered on an expedited basis is an “urgent health-care service.” In addition, this Amendment provides that any compensation paid to a health-care provider or consulting health-care provider for review of a clean pre-authorization request submitted by a health-care provider other than a physician, or of an appeal from an adverse determination of such a request, may not be contingent upon the outcome of the review.

This Amendment clarifies that a health-care provider may determine that a covered health-care service delivered on an expedited basis is an “urgent health-care service.” In addition, this Amendment provides that any compensation paid to a health-care provider or consulting health-care provider for review of a clean pre-authorization request submitted by a health-care provider other than a physician, or of an appeal from an adverse determination of such a request, may not be contingent upon the outcome of the review.

What This Bill Does

  • This Amendment clarifies that a health-care provider may determine that a covered health-care service delivered on an expedited basis is an “urgent health-care service.” In addition, this Amendment provides that any compensation paid to a health-care provider or consulting health-care provider for review of a clean pre-authorization request submitted by a health-care provider other than a physician, or of an appeal from an adverse determination of such a request, may not be contingent upon the outcome of the review.
  • This Amendment clarifies that a health-care provider may determine that a covered health-care service delivered on an expedited basis is an “urgent health-care service.” In addition, this Amendment provides that any compensation paid to a health-care provider or consulting health-care provider for review of a clean pre-authorization request submitted by a health-care provider other than a physician, or of an appeal from an adverse determination of such a request, may not be contingent upon the outcome of the review.

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2025-05-14 Delaware General Assembly

    Introduced and Placed With Bill

Official Summary Text

This Amendment clarifies that a health-care provider may determine that a covered health-care service delivered on an expedited basis is an “urgent health-care service.”
In addition, this Amendment provides that any compensation paid to a health-care provider or consulting health-care provider for review of a clean pre-authorization request submitted by a health-care provider other than a physician, or of an appeal from an adverse determination of such a request, may not be contingent upon the outcome of the review.
This Amendment clarifies that a health-care provider may determine that a covered health-care service delivered on an expedited basis is an “urgent health-care service.”
In addition, this Amendment provides that any compensation paid to a health-care provider or consulting health-care provider for review of a clean pre-authorization request submitted by a health-care provider other than a physician, or of an appeal from an adverse determination of such a request, may not be contingent upon the outcome of the review.