Delaware Legislation

HB 220 amends section 3343, Title 18 and section 3571V, Title 18 of the Delaware Code by requiring health benefit plans that cover prescription drugs to place at least one formulation of each of the FDA-approved MAT drugs on the lowest tier of the carrier’s prescription drug formulary. Such drugs must be covered without prior authorization. Additionally, the bill requires that at least one formulary of each medication within each tier be available without  step-therapy requirements.  Finally, plans must provide coverage for fees associated with the dispensing and administration of methadone at opioid treatment programs

• Make it clear that large employer fully-insured plans have to comply with the Federal Parity Law
• Require large employer fully-insured plans to cover at least 30 consecutive days of inpatient care

• $50,000 annual maximum for applied behavior analysis
• Plans can review a child’s treatment plan once every 6 months