SB 309 — AN ACT TO AMEND TITLE 24 OF THE DELAWARE CODE RELATING TO THE PRACTICE OF CHIROPRACTIC.

Summary

Section 716(a) of Title 24 prohibits annual or lifetime numerical limits on chiropractic visits for the treatment of back pain. The treatment of chronic back pain through chiropractic supportive care can prevent patients from requiring opioid pain medications or more expensive treatments. This Act prohibits the denial of insurance coverage under § 716(a) for chiropractic supportive care, which constitutes maintenance therapy. This requirement applies to policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2023. In addition, this Act clarifies, but does not expand, the insurance coverage subject to the requirements under § 716(a), states that the requirements under this subsection cannot be waived by contract, and requires that the regulations implementing § 176 establish utilization review standards. This Act also updates the definitions in Chapter 7 of Title 24 to be consistent with the current scope of chiropractic practice and makes corresponding revisions to the terms used in existing law. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.

Bill Text

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The bill updates and clarifies definitions related to chiropractic practices and insurance coverage for chiropractic supportive care, prohibiting insurance denial for maintenance therapy and ensuring no limits on chiropractic visits for back pain treatment.

• Section 701, Title 24 of the Delaware Code

  As used in For purposes of this chapter: → As used in this chapter:

  Clarifies the introductory phrase of the definitions section.

• Section 701, Title 24 of the Delaware Code

  “Chiropractic supportive care” means continuous, interval-based treatment that is medically necessary for patients diagnosed with chronic pain or disease, which maintains function or prevents or slows deterioration. → “Chiropractic supportive care” means continuous, interval-based treatment that is medically necessary for patients diagnosed with chronic pain or disease, which maintains function or prevents or slows deterioration. “Chiropractic supportive care” includes treatment for patients who must resume care because the patient’s chronic pain or disease regresses or worsens after the withdrawal of treatment.

  Adds clarification to the definition of chiropractic supportive care.

• Section 707, Title 24 of the Delaware Code

  An applicant who is applying for licensure as a doctor of chiropractic under this chapter shall submit evidence, verified by oath and satisfactory to the Board, that such person: → An applicant applying for licensure as a doctor of chiropractic under this chapter shall submit evidence, verified by oath and satisfactory to the Board, that such person:

  Modifies the phrasing for clarity in the licensure application requirement.

• Section 712, Title 24 of the Delaware Code

  No person may practice chiropractic in this State who has not been licensed in accordance with this chapter. → Except as provided under subsection (b) of this section, no person may practice chiropractic in this State who has not been licensed in accordance with this chapter.

  Clarifies the conditions under which chiropractic practice is regulated.

• Section 716(a), Title 24 of the Delaware Code

  the plan or contract may not have annual or lifetime numerical limits on chiropractic visits for the treatment of back pain. → and such plans and contracts the plan or contract may not have annual or lifetime numerical limits on chiropractic visits for the treatment of back pain.

  Ensures that insurance plans cannot limit chiropractic visits for back pain.

• Section 716(a)(1), Title 24 of the Delaware Code

  coverage for chiropractic supportive care on the basis that the chiropractic supportive care constitutes maintenance therapy. → coverage for chiropractic supportive care on the basis that the chiropractic supportive care constitutes maintenance therapy. This subsection applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2023.

  Prohibits denial of coverage for maintenance therapy and sets a compliance date for new insurance policies.

• Section 716, Title 24 of the Delaware Code

  Nothing in this section shall prevent prevents the operation of reasonable and nondiscriminatory cost containment or managed care provisions, including but not limited to, deductibles, coinsurance, allowable charge limitations, coordination of benefits and utilization review. → Nothing in this section shall prevent the operation of reasonable and nondiscriminatory cost containment or managed care provisions, including but not limited to, deductibles, coinsurance, allowable charge limitations, coordination of benefits, and utilization review.

  Corrects the phrasing for clarity regarding cost containment measures.

• Section 716(c), Title 24 of the Delaware Code

  necessary for the administration, effectuation, investigation, and enforcement of this section. → necessary for the administration, effectuation, investigation, and enforcement of this section, including the establishment of appropriate utilization review standards.

  Adds the requirement for establishing utilization review standards in regulations.

Action History

1. November 02, 2022

   Signed by Governor

2. June 23, 2022

   Passed By House. Votes: 39 YES 2 ABSENT

3. June 15, 2022

   Reported Out of Committee (Health & Human Development) in House with 5 Favorable, 3 On Its Merits

4. June 10, 2022

   Assigned to Health & Human Development Committee in House

5. June 09, 2022

   Passed By Senate. Votes: 20 YES 1 ABSENT

6. June 09, 2022

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

7. June 09, 2022

   Assigned to Finance Committee in Senate

8. June 08, 2022

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

9. June 03, 2022

   Re-Assigned to Banking, Business & Insurance Committee in Senate

10. June 02, 2022

    Introduced and Assigned to Legislative Oversight & Sunset Committee in Senate

Sponsors

• Stephanie L. Hansen · Primary
• Darius J. Brown · Primary
• Bryan Townsend · Primary
• John "Jack" Walsh · Primary
• Debra Heffernan · Primary
• Dave G. Lawson · Cosponsor
• David P. Sokola · Cosponsor
• Kevin S Hensley · Cosponsor
• Kendra Johnson · Cosponsor
• Larry Lambert · Cosponsor
• John A. Kowalko · Cosponsor
• Paul S. Baumbach · Cosponsor
• Sarah McBride · Cosponsor
• Bruce C. Ennis · Cosponsor
• David Bentz · Primary

Votes

Subjects