18 Del. Admin. Code § 1317-1.0
Current through Register Vol. 28, No. 5, November 1, 2024
Section 1317-1.0 - Purpose and Statutory Authority1.1 The purpose of this Regulation is to implement 18 Del.C. §§ 3370A and 3571S, which require (1) health insurers to maintain accurate and complete provider directories, to update provider directories frequently, to audit the accuracy and completeness of such directories and make the directories easily accessible to covered persons in a variety of formats, and (2) facility-based providers and non-network providers to provide timely written out-of-network disclosures to patients that fully inform such patients of the potential that out-of-network providers may be rendering care and the associated costs thereof. This Regulation is promulgated pursuant to 18 Del.C. §§ 3370A and 3571S; and 29 Del.C. Ch. 101. This Regulation should not be construed to create any cause of action not otherwise existing at law.1.2 Consistent with 18 Del.C. §§ 3370A and 3571S, this regulation applies to every policy or contract of health insurance which is delivered or issued for delivery in this State, including each policy or contract issued by a health-service corporation, which provides medical, major medical, or similar comprehensive-type coverage, and which designates network physicians or providers (hereinafter referred to collectively as "network providers"). However, this regulation applies only to items, services or conditions for which coverage is provided by those policies or contracts (hereinafter referred to as "covered services").18 Del. Admin. Code § 1317-1.0
20 DE Reg. 645 (2/1/2017) (Final)