Delaware · House Bill 212 · 153rd General Assembly

Insurance Overpayment/Updated Requirements

HB 212 Sponsored by William Bush Withdrawn

  1. Introduced Jun 10, 2025
  2. In committee Jun 10, 2025
  3. Withdrawn  
  4. Passed the Senate  
  5. To the governor  
  6. Became law  

What it does

The legislature's own summary of the bill, or its official long title.

Section 1 of this Act amends the time period during which health insurers may initiate overpayment recovery efforts from 24 months to 12 months of a claim being paid. This Act also amends one of the exemptions to the overpayment recovery deadline to require an indication of fraud, abuse, or other intentional misconduct based on a physical review or review of claims data or statements as opposed to merely having a…

Read the full title (211 words)

Section 1 of this Act amends the time period during which health insurers may initiate overpayment recovery efforts from 24 months to 12 months of a claim being paid. This Act also amends one of the exemptions to the overpayment recovery deadline to require an indication of fraud, abuse, or other intentional misconduct based on a physical review or review of claims data or statements as opposed to merely having a reasonable belief of such fraud, abuse or other intentional misconduct. It aligns requirements for provider-oriented clawbacks with those for pharmacies. Section 2 of this Act requires written notice from pharmacy benefit managers or entities conducting pharmacy audits. Because Department examinations have indicated that PBMs misuse this provision in the law to conduct audits outside the parameters of the Pharmacy Audit Integrity Program, Section 3 of this Act amends the exclusions to the applicability of the pharmacy audit rules to require that pharmacy benefits managers have more definitive proof, based on physical review of claims data or other investigative methods, to believe misconduct has occurred before the rules related to the Pharmacy Audit Integrity Program become inapplicable to an investigative audit. This Act also makes technical corrections to existing law to conform to the requirements of the Delaware Legislative Drafting Manual.

Every action

8 steps, oldest first, as the legislature records them.

  1. CommitteeIntroduced and Assigned to Economic Development/Banking/Insurance & Commerce Committee in House · House Economic Development/Banking/Insurance & Commerce
  2. CommitteeReported Out of Committee (Economic Development/Banking/Insurance & Commerce) in House with 2 Favorable, 9 On Its Merits · House Economic Development/Banking/Insurance & Commerce
  3. HouseSubstituted in House by HS 1 for HB 212
  4. HouseHS 1 for HB 212 - Passed By House. Votes: 40 YES 1 VACANT
  5. SenateHS 1 for HB 212 - Assigned to Banking, Business, Insurance & Technology Committee in Senate
  6. SenateHS 1 for HB 212 - Reported Out of Committee (Banking, Business, Insurance & Technology) in Senate with 7 On Its Merits
  7. SenateHS 1 for HB 212 - Passed By Senate. Votes: 21 YES
  8. HS 1 for HB 212 - Signed by Governor

Roll calls

No recorded votes on this bill yet.

Sponsors

The member who introduced it, joined by 3 cosponsors: 2 Democrats, 1 Republican.

All 3 cosponsors

From Delaware's official records (legis.delaware.gov), checked Nov 1, 2026. Text links go to the official versions; LegiList does not copy bill text.