DEL LEG Pharmacist Reimbursement


On Jun. 25, DEL LEG passed bill on coverage for pharmacist services.


  • DEL LEG passed SB 272 requiring insurance reimbursement for pharmacists' services.
  • Codified DEL INS 18-23-2321 (unfair practices), DEL INS 18-33-3370G (contracts).
  • DEL INS 18-35-3571AA, DEL INS 29-52-5218, DEL INS 31-5-502 on insurance.
  • Background
  • General Assembly has recently added to the services that pharmacists may provide.
  • Including prescribing birth control, pre-exposure and post-exposure HIV prophylaxis.
  • Insurers do not recognize pharmacists as providers who may seek reimbursement for these services despite providing coverage for the same services from other providers.
  • May lead to pharmacists not providing expanded services due to lack of coverage.
  • Rule Provisions
  • Insurers must provide same reimbursement to pharmacists issued to other providers.
  • Performing the same services at the same rates as advanced practice registered nurses and physician assistants; pharmacist must be acting within scope of practice.
  • Legislative History
  • On Apr. 23, 2024, bill was introduced in Senate; on May 16, 2024, bill passed Senate.
  • On May 21, 2024, bill was introduced in House; on Jun. 25, 2024, bill passed House.
  • Effectiveness
  • Upon approval, bill takes effect Jan. 1, 2025.
  • Sep. 2024 DEL LEG Bill Approval
  • On Sep. 24, 2024, DEL LEG governor approved bill as Ch. 421, effective Jan. 1, 2025.
  • Document dated Sep. 24, 2024, was added on Oct. 7, 2024 due to a fixed feed.

Regulators DEL LEG
Entity Types Ins
Reference Ch 421, 9/24/2024; Bill SB272, 6/25/2024; Citation: *DEL INS* 18-23, 18-33, 18-35, 29-52, 31-5;
Functions Compliance; Legal
Countries United States of America
Category
State
Products Insurance; Insurance-Health
Regions Am
Rule Type Final
Rule Date 6/25/2024
Effective Date 1/1/2025
Rule Id 217227
Linked to N/A
Reg. Last Update 9/24/2024
Report Section US Insurance

Last substantive update on 10/08/2024