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SB12 • 2025

AN ACT TO AMEND TITLE 18 AND TITLE 29 OF THE DELAWARE CODE RELATING TO THE DELAWARE PRE AUTHORIZATION ACT OF 2025.

AN ACT TO AMEND TITLE 18 AND TITLE 29 OF THE DELAWARE CODE RELATING TO THE DELAWARE PRE AUTHORIZATION ACT OF 2025.

Passed Legislature

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

Sponsor
Last action
2025-05-15
Official status
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.

AN ACT TO AMEND TITLE 18 AND TITLE 29 OF THE DELAWARE CODE RELATING TO THE DELAWARE PRE AUTHORIZATION ACT OF 2025.

AN ACT TO AMEND TITLE 18 AND TITLE 29 OF THE DELAWARE CODE RELATING TO THE DELAWARE PRE AUTHORIZATION ACT OF 2025.

What This Bill Does

  • AN ACT TO AMEND TITLE 18 AND TITLE 29 OF THE DELAWARE CODE RELATING TO THE DELAWARE PRE AUTHORIZATION ACT OF 2025.
  • This Legislation is the Delaware Pre-Authorization Reform Act of 2025.
  • Section 1 of the Act applies to health Insurance Contracts regulated under Chapter 33 of Title 18.
  • Section 1 provides that changes in utilization review terms for a health-care service, such as the clinical criteria used to conduct utilization reviews for a health-care service, will apply only upon re-authorization of the health-care service.

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.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

SA 1

1 • Townsend

Passed 5/15/25

Plain English: Legislation Document SPONSOR: Sen.

  • Legislation Document SPONSOR: Sen.
  • Townsend DELAWARE STATE SENATE 153rd GENERAL ASSEMBLY SENATE AMENDMENT NO.
  • 1 TO SENATE BILL NO.
  • 12 AMEND Senate Bill No.

Bill History

No action history is stored for this bill yet.

Official Summary Text

AN ACT TO AMEND TITLE 18 AND TITLE 29 OF THE DELAWARE CODE RELATING TO THE DELAWARE PRE AUTHORIZATION ACT OF 2025.
This Legislation is the Delaware Pre-Authorization Reform Act of 2025.

Section 1 of the Act applies to health Insurance Contracts regulated under Chapter 33 of Title 18.

Section 1 provides that changes in utilization review terms for a health-care service, such as the clinical criteria used to conduct utilization reviews for a health-care service, will apply only upon re-authorization of the health-care service. Covered persons must be notified at least 6 months before any changes to utilization review terms, except in certain circumstances such as changes in clinical guideline status

In addition, Section 1 sets qualifications for who may make determinations with regard to requests for pre- authorization of health-care services and appeals of adverse determinations; a timeline and required contents for the notification of an outcome of appeal of an adverse determination or a notification that additional information is necessary to make the determination of appeal; and requir