HB 350 — AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO HOSPITAL COSTS.
Last action — Signed by Governor
-
✓Introduced
-
✓In Committee
-
✓Passed House
-
✓Passed Senate
-
✓To Executive
-
6Enacted
This bill has been enacted into law. Introduced April 23, 2024. Enacted.
Odds of enactment
High chanceBased on the sponsor, cosponsors, and committee posture, this bill has a high chance of becoming law.
Upgrade to see the exact probability and what's driving it.
A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.
Prognosis
-
Enacted
Current position in the legislative process.
-
3 sponsors
3 primary, 0 co-sponsors signed on.
-
Single-party support
Sponsorship is currently within one party (2 D).
-
Cleared a recorded vote
Passed 3 recorded votes so far.
Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.
Summary
This Act creates the Diamond State Hospital Cost Review Board, which will be responsible for an annual review of hospital budgets and related financial information. The Board will have 7 members: 6 appointed by the Governor and confirmed by the Senate, and the Executive Director of the Delaware Healthcare Association. This Act creates a requirement that hospitals submit yearly budgets, audited financial statements, and related financial information to the Board for review. Where a hospital fails to meet the state’s budget benchmark for increases in hospital costs it is required to engage with the Board on a performance improvement plan. If the Board and the hospital cannot agree on an improvement plan or where the hospital fails to successfully implement a performance plan, the Board may require the hospital to have its future budget approved by the Board. The submission of hospital budget and financial information will begin in 2025 for calendar year 2026. In reviewing performance improvement plans or proposed budgets, the Board will consider adherence as closely to the spending benchmark as is reasonable given the hospital’s financial position and associated economic factors, the promotion of efficient and economic operations of the hospital, and maintenance of the hospital’s ability to meet its financial obligations and provide quality health care. As a temporary measure until the Board begins operations, hospitals are required to charge no more than 250% of Medicare costs to any payer for hospital services in calendar year 2025. This Substitute Bill incorporates all of the following changes which were incorporated into House Substitute No. 1 for House Bill No. 350: It provides additional detail regarding the operation of the Board, budget modifications, and provides an appeal right to the Superior Court. It changes the application of the definition of hospital to exclude psychiatric facilities. Because hospitals may have different fiscal years, the deadline for the Board to issue a final decision on a budget is changed to 90 days before the start of a hospital’s fiscal year rather than a fixed date. The confidentiality provisions for hospital records have been updated. Technical corrections have been made. In addition, House Substitute No. 2 contains the following changes: It adds a performance improvement plan process as an interim step prior to requiring a hospital to submit a proposed budget for approval or modification by the Board. With this change, the Board will only accept and review budget information in its first year of operation in 2025. In 2026, it may direct hospitals to submit a performance improvement plan. It exempts hospitals that are exclusively rehabilitative hospitals. It changes the composition of the Board as set forth above. It exempts hospitals who derive 45% or more of their revenue or whose patient population has 5% or less Medicare patients from the 2025 reference pricing provision. It extends the interim reference pricing period to include 2026 and prohibits balance billing in reference pricing period.
Bill Text
What changed in the latest version
241 added · 36 removed241 line(s) added, 36 removed.
Longhurst HOUSE& OFRep. REPRESENTATIVES 152nd GENERAL ASSEMBLY HOUSE AMENDMENT NO.
1Harris TO& HOUSESen. SUBSTITUTE NO.
Townsend HOUSE OF REPRESENTATIVES 152nd GENERAL ASSEMBLY HOUSE SUBSTITUTE NO.
350 AN ACT TO AMEND HouseTITLE Substitute16 No.OF THE DELAWARE CODE RELATING TO HOSPITAL COSTS.
2BE forIT HouseENACTED BillBY No.THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:
350Section by1. deleting lines 24 through 27 in their entirety and substituting in lieu thereof the following:
“(b)Amend (1)Subchapter TheI, BoardChapter consists99, Title 16 of 8the membersDelaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:
§ 9903.
Duties and authority of the Commission.
(l) The Commission is responsible for the administration of the Diamond State Hospital Cost Review Board.
The Commission shall have such other duties and authorities with respect to the Diamond State Hospital Cost Review Board as are necessary to carry out the intent of the General Assembly as expressed in this chapter.
Section 2.
Amend Chapter 99, Title 16 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:
Subchapter VI.
Hospital Budget Review § 9951.
Definitions.
As used in this subchapter:
(1) “Board” means the Diamond State Hospital Cost Review Board established by § 9952 of this title.
(2) “Hospital” means as defined in § 1001 of this title, except that hospitals that exclusively provide psychiatric services or rehabilitative services are excluded from the application of this subchapter.
(3) “Insurers” means as defined in § 9903 of this title.
(4) “Payer” means as defined in § 9903 of this title.
(5) “Public programs” means as defined in § 9903 of this title.
(6) “Purchaser” means any governmental entity or unit, which offers coverage on a self-insured basis, or any employer that is self-insured within the definitions of the Employee Retirement Income Security Act (ERISA).
(7) “Spending benchmark” means as defined in § 9903 of this title.
§ 9952.
Diamond State Hospital Cost Review Board.
HD :
KL :
DS Page 1 of 8 Released:
04/23/2024 12:22 PM (a) There is established the Diamond State Hospital Cost Review Board for the purpose of carrying out hospital budget reviews and related functions under this chapter.
(b) (1) The Board consists of 7 members as follows:
SevenSix voting members appointed by the Governor and confirmed by a majority of the members elected to the Senate.
The PresidentExecutive andDirector CEO of the Delaware HealthcareHospital Association,Association. who shall serve as a non-voting member.”.
FURTHER(2) AMENDThe Housemembers Substituteappointed No.by the Governor shall serve a 4-year term, except that the initial members may be appointed for a term less than 4 years to create staggered terms.
2A formember Houseshall Billcontinue No.to serve on the Board until the member’s successor has been appointed and qualified.
350A onmember linemay 43serve bymore deletingthan “Four1 members”term. and inserting in lieu thereof “Four voting members”.
FURTHER(3) AMENDThe HouseGovernor Substituteshall No.designate a member appointed by the Governor to serve as Chair of the Board, who shall serve as Chair at the pleasure of the Governor.
2(c) forAll Housemembers Billof No.the Board appointed by the Governor must possess the following qualifications:
350(1) onKnowledge lineof 45health bycare insertingpolicy, “votinghealth memberscare ofdelivery, the”or beforebusiness, “Board:”finance, asor itaccounting. appears therein.
FURTHER(2) AMENDKnowledge, Houseexperience, Substituteand No.characteristics that complement those of the remaining members of the Board.
Show all 197 changed lines (157 more)
2(3) forImpartiality Houseand Billthe No.ability to remain free from undue influence by a personal, business, or professional relationship with any person subject to supervision or regulation by the Board.
350(d) byThe deletingChair linesof 52the throughDelaware 55Health Care Commission shall set the date for the initial meeting of the Board and insertingshall inset lieuthe thereofdate of the following:next meeting if the Chair is vacant.
Ҥ(e) 9953.The members of the Board appointed by the Governor shall each receive a salary as appropriated in the Budget Appropriation Bill, to be paid in equal monthly payments by the Treasurer of the State.
Submission(f) and(1) analysisFour members constitutes a quorum of hospitalthe financialBoard information.and, except as set forth in paragraph (f)(2) of this section, the Board may take action by affirmative vote of a majority of members present and voting.
(a)(2) HospitalsThe shallfollowing annuallyactions submitrequire to the Boardaffirmative anyvote of thea followingmajority informationof required by the BoardBoard: under rules, regulations, and guidance promulgated under this subchapter:
(1)a. A budget for the forthcoming year, including expenditures and revenues, redlined to reflect increases and changes from the previous year.”.
FURTHERApproval AMENDof Housea Substitutehospital No.budget.
2b. for House Bill No.
350Revision byof deletinga linehospital 65budget. in its entirety and redesignating accordingly.
FURTHERc. AMEND House Substitute No.
2An forenforcement Houseaction Billunder No.§ 9957 of this title.
350d. by deleting lines 73 and 74 in their entirety and inserting in lieu thereof the following:
Approval of a performance improvement plan under § 9954 of this title.
(g) The Board shall promulgate rules and regulations necessary for the implementation of this subchapter including a schedule for submission of information required from hospitals under § 9953 of this title.
SCDDS Page 12 of 28 Released:
04/25/202404/23/2024 05:4912:22 PM “(2) Consider the expenditure and revenue analysis for the previous year and the proposed expenditure and revenue analysis for the forthcoming year and determine whether the hospital has satisfied the State’s health care spending policy directives, including the health care spending benchmark and the annual rate filing cost containment requirements under § 25039953. of Title 18.”.
SYNOPSISSubmission Thisof amendmentfinancial changesinformation the Delaware Healthcare Association member to a non-voting member of the BoardBoard. and adds 1 additional member appointed by the Governor.
It(a) alsoHospitals makesshall someannually technicalsubmit clarificationsall of the following information to the budgetBoard submissionat the time and reviewplace process.and in the manner established by the Board:
(1) A budget for the forthcoming year, including expenditures and revenues.
(2) Spending and revenue data from the previous year.
(3) Financial information, including costs of operations, revenues, assets, liabilities, fund balances, rates, charges, units of service, and wage and salary data.
(4) Scope of services and volume of service information, including inpatient services, outpatient services, and ancillary services by type of service provided.
(5) Utilization information.
(6) New hospital services and programs proposed for the forthcoming year.
(7) Projected 3-year capital budget.
(8) Contract information with public and private payers and purchasers.
(9) A comparison of the hospital’s cost of service to other comparable hospitals in the region.
(10) Other information the Board determines to be relevant to the budget review process.
(b) Hospitals shall submit audited financial statements to the Board, within 30 days of such audited financial statements becoming finalized.
This requirement begins with audited financial statements for 2023.
(c) The Board shall conduct reviews of each hospital’s proposed budget based on the information provided pursuant to subsection (a) of this section.
(d) In connection with budget reviews, the Board shall do all of the following:
(1) Review utilization information.
(2) Consider the expenditure and revenue analysis for the previous year and the proposed expenditure and revenue analysis for the forthcoming year.
(3) Meet with hospitals to review and discuss their budget proposals for the forthcoming year.
(4) Review the hospital’s investments in workforce development initiatives.
(5) Consider the salaries for the hospital’s executive and clinical leadership and the hospital’s salary spread, including a comparison to salaries in other states in the region.
(6) Offer the opportunity for the public to provide comment on hospital budgets and other aspects of hospital costs.
SCDDS Page 23 of 28 Released:
04/25/202404/23/2024 05:4912:22 PM 028152015181 (e) A hospital’s violation of the Board’s standards and procedures is subject to enforcement under § 9957 of this title.
§ 9954.
Performance improvement plans.
(a) Beginning in 2026, if the Board determines that a hospital’s actual annual cost growth has exceeded the spending benchmark, the Board shall send the hospital notice of that finding and may require the hospital to submit a performance improvement plan within 45 days.
(b) A proposed performance improvement plan submitted by a hospital must identify the causes of the hospital’s cost growth and must include specific strategies, adjustments, and action steps the hospital proposes to implement to improve cost performance.
The proposed performance improvement plan must include specific identifiable and measurable expected outcomes and a timetable for implementation.
The timetable for a performance improvement plan may not exceed 12 months.
(c) If the Board determines that the performance improvement plan is unacceptable or incomplete, the Board shall provide written guidance explaining the criteria that have not been met and may provide an additional time period, up to 30 calendar days, for resubmission.
If the hospital and the Board are unable to agree to a performance improvement plan, the Board may require the hospital to submit to the budget approval process under § 9955 of this title.
(d) If the Board determines that the performance improvement plan is acceptable, the Board shall notify the hospital of the approval of the plan.
A hospital implementing an approved performance improvement plan may be subject to additional reporting requirements and compliance monitoring, at the discretion of the Board.
(e) At the conclusion of the timetable established in the performance improvement plan, or at an earlier time determined by the Board, the hospital shall report to the Board regarding the progress or outcome of the performance improvement plan.
If the Board finds that the performance improvement plan has not been successful, the Board may do one of the following:
(1) Extend the implementation timetable of the existing performance improvement plan.
(2) Require the hospital to submit a new performance improvement plan.
(3) Require the hospital to participate in the budget approval process under § 9955 of this title.
(f) When determining whether to approve a performance improvement plan or an amendment thereto under this section the Board shall consider whether the proposal will be effective in achieving the factors set forth under § 9955(c) of this title.
§ 9955.
Approval or modification of hospital budget.
HD :
KL :
DS Page 4 of 8 Released:
04/23/2024 12:22 PM (a) If a hospital has undertaken a performance improvement plan under § 9954 of this title and failed to show sufficient progress or has failed to submit an acceptable performance improvement plan under § 9954 of this title, the hospital may be required to submit the next fiscal year’s budget to the Board for review and approval.
(b) When a hospital budget is submitted for approval under this section, the Board shall approve a hospital’s budget as submitted or engage with the hospital in establishing and approving a modified budget.
A budget must be approved as submitted or as modified by 90 days before the start of the hospital’s fiscal year.
Each hospital shall operate under the original or modified budget as approved.
(c) Individual hospital budgets approved under this section shall:
(1) Adhere as closely to the spending benchmark as is reasonable given the hospital’s financial position and associated economic factors.
(2) Promote efficient and economic operations of the hospital.
(3) Maintain the hospital’s ability to meet its financial obligations and provide quality care.
(d) The Board may not require a hospital budget to be modified if the budget submitted reflects growth equal to or less than the spending benchmark.
(e) If the Board and a hospital cannot agree on a modified budget, the Board may impose a modified budget and shall issue a written decision enumerating the reasons why the Board’s modified budget will satisfy the factors under subsection (c) of this section.
(f) The Board may, upon application, adjust a budget established under this section during the fiscal year upon demonstration of need based on exceptional or unforeseen circumstances.
(g) The Board may request, and a hospital shall provide, information determined by the Board to be necessary to determine whether the hospital is operating within a budget established under this section.
(h) When a hospital has successfully met its budget goals for 3 consecutive years, the hospital may no longer be required to participate in the budget approval process under this section.
§ 9956.
Appeal from a final decision of the Board.
(a) A hospital affected by any final decision of the Board may appeal from such order to the Superior Court within 30 days from the date upon which such decision is served.
The appeal shall be filed with the Prothonotary of the Superior Court and the summons in the appeal shall be served upon the Chair of the Board and the Secretary of the Department of Health and Social Services, either personally or by certified mail.
(b) The appeal shall be based upon the record created before the Board.
HD :
KL :
DS Page 5 of 8 Released:
04/23/2024 12:22 PM (c) The scope of review before the Court shall be that the Board’s findings shall be upheld if they are supported by sufficient evidence, free of error of law, and not arbitrary or capricious.
When factual issues are reviewed the Court shall take due account of the presumption of official regularity and the specialized competence of the Board.
§ 9957.
Enforcement.
(a) A hospital that knowingly fails to provide information or adhere to standards, procedures, and deadlines related to the budget review process as required by this subchapter or a rule or regulation promulgated thereunder may be assessed a civil penalty of up to $500,000.
(b) In the event that a hospital subject to budget approval under § 9955 of this title fails to maintain its approved budget, the Board may do any of the following:
(1) Factor the amount of net revenues exceeding the budgeted amount of net revenues into the hospital’s budget for the forthcoming year.
(2) Allow the hospital to retain surplus funds if the surplus was achieved while the hospital stayed within its budget.
(3) Allow the hospital to retain surplus funds generated primarily by volume in excess of what was projected for the year in question.
(4) Impose a penalty on the hospital in an amount up to the net revenues exceeding the budgeted amount of net revenues.
The penalty shall be paid into a Community Health Fund, hereby created, and held in the Office of the Treasurer.
The State Treasurer shall invest the Fund consistent with the investment policies established by the Cash Management Policy Board and credit interest to the Fund monthly consistent with the rate established by the Cash Management Policy Board.
(c) An order under subsection (a) or paragraph (b)(4) of this section may be issued only after a hospital has received notice and an opportunity to be heard by the Board.
§ 9958.
Open meetings;
records subject to disclosure.
(a) The Board is a public body, subject to the open meetings requirement of § 10004 of Title 29;
provided, however, that the Board may schedule and conduct private meetings with hospitals when the content of the discussion will include information that is commercial or financial information of a privileged or confidential nature.
(b) (1) Except as provided under paragraph (b)(2) of this section, records submitted by hospitals to the Board are not public records for purposes of the Freedom of Information Act.
(2) The following are public records and shall be posted on the Board’s or the Commission’s website:
a.
Original and modified budgets.
HD :
KL :
DS Page 6 of 8 Released:
04/23/2024 12:22 PM b.
Spending and revenue data.
c.
Utilization information.
Section 3.
Amend Chapter 99, Title 16 by making deletions as shown by strike through and insertions as shown by underline as follows:
§ 9959.
Temporary pricing measures for calendar year 2025 and 2026.
(a) Except as provided in subsection (c) of this section, for the calendar years 2025 and 2026, a hospital may not charge any payer, purchaser, insurer, or public program more than 250% of the cost of care charged to the Medicare program for any service.
(b) A hospital may not charge or collect from a patient or any other individual or entity any amount that exceeds the amount permitted to be billed under subsection (a) of this section for any service.
(c) This section does not apply to a hospital that serves less than 5% Medicare eligible patients per year or a hospital that derives 45% or more of its revenue from Medicaid or uninsured patients.
Section 4.
Sections 1 and 2 of this Act are effective upon enactment, and hospitals, in accordance with regulations and guidance promulgated by the Board, are required to begin submission of budget information under § 9953 of Title 16 in 2025 for the 2026 budget year.
The Board may require the submission of more than 1 year of historical financial information in its initial year of operation.
The Board may not require the submission of a performance improvement plan under § 9954 of Title 16 until 2026.
Section 5.
Section 3 of this Act is effective upon enactment and sunsets on January 1, 2027, unless otherwise provided by a subsequent act of the General Assembly.
SYNOPSIS This Act creates the Diamond State Hospital Cost Review Board, which will be responsible for an annual review of hospital budgets and related financial information.
The Board will have 7 members:
6 appointed by the Governor and confirmed by the Senate, and the Executive Director of the Delaware Healthcare Association.
This Act creates a requirement that hospitals submit yearly budgets, audited financial statements, and related financial information to the Board for review.
Where a hospital fails to meet the state’s budget benchmark for increases in hospital costs it is required to engage with the Board on a performance improvement plan.
If the Board and the hospital cannot agree on an improvement plan or where the hospital fails to successfully implement a performance plan, the Board may require the hospital to have its future budget approved by the Board.
The submission of hospital budget and financial information will begin in 2025 for calendar year 2026.
In reviewing performance improvement plans or proposed budgets, the Board will consider adherence as closely to the spending benchmark as is reasonable given the hospital’s financial position and associated economic factors, the promotion of efficient and economic operations of the hospital, and maintenance of the hospital’s ability to meet its financial obligations and provide quality health care.
As a temporary measure until the Board begins operations, hospitals are required to charge no more than 250% of Medicare costs to any payer for hospital services in calendar year 2025.
This Substitute Bill incorporates all of the following changes which were incorporated into House Substitute No.
1 for House Bill No.
350:
It provides additional detail regarding the operation of the Board, budget modifications, and provides an appeal right to the Superior Court.
HD :
KL :
DS Page 7 of 8 Released:
04/23/2024 12:22 PM It changes the application of the definition of hospital to exclude psychiatric facilities.
Because hospitals may have different fiscal years, the deadline for the Board to issue a final decision on a budget is changed to 90 days before the start of a hospital’s fiscal year rather than a fixed date.
The confidentiality provisions for hospital records have been updated.
Technical corrections have been made.
In addition, House Substitute No.
2 contains the following changes:
It adds a performance improvement plan process as an interim step prior to requiring a hospital to submit a proposed budget for approval or modification by the Board.
With this change, the Board will only accept and review budget information in its first year of operation in 2025.
In 2026, it may direct hospitals to submit a performance improvement plan.
It exempts hospitals that are exclusively rehabilitative hospitals.
It changes the composition of the Board as set forth above.
It exempts hospitals who derive 45% or more of their revenue or whose patient population has 5% or less Medicare patients from the 2025 reference pricing provision.
It extends the interim reference pricing period to include 2026 and prohibits balance billing in reference pricing period.
HD :
KL :
DS Page 8 of 8 Released:
04/23/2024 12:22 PM 3501520266
Show all 197 changed rows (157 more)
Action History
-
Signed by Governor
-
Passed By House. Votes: 24 YES 16 NO 1 ABSENT
-
Passed By Senate. Votes: 14 YES 7 NO
-
Amendment SA 1 to HS 2 - Passed By Senate. Votes: 15 YES 6 NO
-
Reported Out of Committee (Finance) in Senate with 4 On Its Merits
-
Amendment SA 1 to HS 2 - Introduced and Placed With Bill
-
Assigned to Finance Committee in Senate
-
Reported Out of Committee (Executive) in Senate with 5 On Its Merits
-
Assigned to Executive Committee in Senate
-
Passed By House. Votes: 21 YES 16 NO 4 ABSENT
-
Motion to Table HS 2 for HB 350 - Failed by Roll Call Vote in House
-
Amendment HA 1 to HS 2 - Passed In House by Voice Vote
-
was introduced and adopted in lieu of HB 350
Sponsors
- Bryan Townsend · Primary
- Kerri Evelyn Harris · Primary
- Valerie Longhurst · Primary
Sponsorship breakdown
Export CSV (upgrade) →3 sponsors · 0 co-sponsors · 59 not signed on · 25 voted No
Sponsors (3)
- Bryan Townsend Democratic
- Kerri Evelyn Harris Democratic
- Valerie Longhurst
Co-sponsors (0)
None.
Not signed on (59)
59 members have not signed on to this bill.
Show all 59 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 5 | 2 | 0 | 0 |
| Democratic | 19 | 1 | 0 | 0 |
| Republican | 0 | 13 | 0 | 1 |
| Total | 24 | 16 | 0 | 1 |
| % of votes cast | 59% | 39% | 0% | 2% |
How each member voted (41)
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 12 | 1 | 0 | 0 |
| Republican | 0 | 6 | 0 | 0 |
| Unaffiliated | 2 | 0 | 0 | 0 |
| Total | 14 | 7 | 0 | 0 |
| % of votes cast | 67% | 33% | 0% | 0% |
How each member voted (21)
| Member | Party | Vote |
|---|---|---|
| Kyle Evans Gay | — | Yea |
| Sarah McBride | — | Yea |
| Bryan Townsend | Democratic | Yea |
| Darius J. Brown | Democratic | Yea |
| David P. Sokola | Democratic | Yea |
| John "Jack" Walsh | Democratic | Yea |
| Kyra L. Hoffner | Democratic | Yea |
| Laura V. Sturgeon | Democratic | Yea |
| Marie Pinkney | Democratic | Yea |
| Nicole Poore | Democratic | Yea |
| Russell Huxtable | Democratic | Nay |
| S. Elizabeth Lockman | Democratic | Yea |
| Spiros Mantzavinos | Democratic | Yea |
| Stephanie L. Hansen | Democratic | Yea |
| Trey Paradee | Democratic | Yea |
| Brian Pettyjohn | Republican | Nay |
| Bryant L. Richardson | Republican | Nay |
| Dave G. Lawson | Republican | Nay |
| David L. Wilson | Republican | Nay |
| Eric Buckson | Republican | Nay |
| Gerald W. Hocker | Republican | Nay |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 3 | 3 | 0 | 1 |
| Democratic | 18 | 1 | 0 | 1 |
| Republican | 0 | 12 | 0 | 2 |
| Total | 21 | 16 | 0 | 4 |
| % of votes cast | 51% | 39% | 0% | 10% |
How each member voted (41)
Subjects
Frequently asked questions
- What does HB 350 do?
- This Act creates the Diamond State Hospital Cost Review Board, which will be responsible for an annual review of hospital budgets and related financial information. The Board will have 7 members: 6 appointed by the Governor and confirmed by the Senate, and the Executive Director of the Delaware Healthcare Association. This Act creates a requirement that hospitals submit yearly budgets, audited financial statements, and related financial information to the Board for review. Where a hospital fails to meet the state’s budget benchmark for increases in hospital costs it is required to engage with the Board on a performance improvement plan. If the Board and the hospital cannot agree on an improvement plan or where the hospital fails to successfully implement a performance plan, the Board may require the hospital to have its future budget approved by the Board. The submission of hospital budget and financial information will begin in 2025 for calendar year 2026. In reviewing performance improvement plans or proposed budgets, the Board will consider adherence as closely to the spending benchmark as is reasonable given the hospital’s financial position and associated economic factors, the promotion of efficient and economic operations of the hospital, and maintenance of the hospital’s ability to meet its financial obligations and provide quality health care. As a temporary measure until the Board begins operations, hospitals are required to charge no more than 250% of Medicare costs to any payer for hospital services in calendar year 2025. This Substitute Bill incorporates all of the following changes which were incorporated into House Substitute No. 1 for House Bill No. 350: It provides additional detail regarding the operation of the Board, budget modifications, and provides an appeal right to the Superior Court. It changes the application of the definition of hospital to exclude psychiatric facilities. Because hospitals may have different fiscal years, the deadline for the Board to issue a final decision on a budget is changed to 90 days before the start of a hospital’s fiscal year rather than a fixed date. The confidentiality provisions for hospital records have been updated. Technical corrections have been made. In addition, House Substitute No. 2 contains the following changes: It adds a performance improvement plan process as an interim step prior to requiring a hospital to submit a proposed budget for approval or modification by the Board. With this change, the Board will only accept and review budget information in its first year of operation in 2025. In 2026, it may direct hospitals to submit a performance improvement plan. It exempts hospitals that are exclusively rehabilitative hospitals. It changes the composition of the Board as set forth above. It exempts hospitals who derive 45% or more of their revenue or whose patient population has 5% or less Medicare patients from the 2025 reference pricing provision. It extends the interim reference pricing period to include 2026 and prohibits balance billing in reference pricing period.
- Who sponsors HB 350?
- HB 350 is sponsored by Bryan Townsend (Democratic), Kerri Evelyn Harris (Democratic), and Valerie Longhurst.
- What is the current status of HB 350?
- This bill has been enacted into law. Introduced April 23, 2024. Enacted.
- Where can I track HB 350?
- Track HB 350 free on One Click Politics — get push/email alerts when it moves.
Make your voice heard on HB 350
Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.
Stay ahead of HB 350
Last checked for changes 2 months ago · updated continuously
One Click Politics tracks every bill in Congress and all 50 states.
Track this bill →