An Act To Amend Title 18 Of The Delaware Code Relating To Health Insurance And Pre-authorization Requirements.
The legislation mandates that changes in coverage terms for any health-care services following a pre-authorization must not take effect until the next plan year for individuals who had received prior authorization. Additionally, it extends the validity period of pre-authorizations from 60 days to 7 months and limits insurers to requiring no more than one pre-authorization per episode of care. These changes are expected to enhance continuity of care for patients transitioning between different health insurance providers.
Senate Bill 10, also known as the Delaware Pre-Authorization Reform Act of 2023, seeks to amend Title 18 of the Delaware Code related to health insurance and pre-authorization requirements. The bill responds to widespread concerns from healthcare providers about the burdensome nature of current pre-authorization processes. It introduces significant changes aimed at streamlining these processes, reducing the administrative burden on medical practices, and ensuring better patient access to necessary medical care.
Overall sentiment surrounding SB10 appears to be positive among healthcare providers and advocates for patient rights, who view it as a necessary reform to ensure timely access to care. However, there may be contention from insurance companies regarding potential impacts on their operational processes and the financial implications of less stringent pre-authorization procedures. The general agreement is that simplifying pre-authorization processes is beneficial for patient care.
Notably, the bill does not address the broader issue of medical necessity determinations strictly during pre-authorizations, which some critics argue could still lead to coverage denials if the underlying service is later deemed unnecessary. Furthermore, there is a concern about the implementation challenges that could arise as insurers adapt to these new pre-authorization timelines and reporting requirements. The focus on reducing bureaucracy must balance the need for maintaining quality and cost control in healthcare delivery.