AN ACT TO AMEND TITLE 6 AND TITLE 16 OF THE DELAWARE CODE RELATING TO HOSPITAL CHARITY CARE AND FINANCIAL ASSISTANCE.
Sponsored By: Marie Pinkney (Democratic)
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Bill Overview
Analyzed Economic Effects
10 provisions identified: 10 benefits, 0 costs, 0 mixed.
Lower hospital bills for Delaware patients
Beginning January 1, 2027, Delaware residents get income-based help for medically necessary hospital care, with or without insurance. Help covers the bill left after insurance: 100% at or below 300% of the federal poverty level, at least 75% above 300% through 350%, and at least 50% above 350% through 400%. Hospitals and providers working within them may offer help above 400%; these minimums exclude hospitals providing only psychiatric, rehabilitation, or long-term acute care. Providers cannot require payment first, a payment plan, or trying other remedies before granting income-based help. Those access protections take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
Debt collection protections for hospital patients
Medical creditors and collectors cannot take extraordinary collection actions against patients who qualify for assistance or whom creditors reasonably know likely qualify. When they know or should know an assistance decision or appeal is pending, they cannot demand payment, sue, arbitrate, refer, or sell the debt. A written notice saying the patient is not responsible for the debt during that period is allowed. During a completed assistance or coverage application's review, hospitals must give that written notice; informed hospitals and providers cannot refer, sell, assign, credit-report, sue, or arbitrate over the charges. These rules take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
Stronger defenses against medical debt lawsuits
In a medical-debt lawsuit, assistance eligibility or the provider's failure to follow the assistance law is a complete defense. Courts cannot grant hospitals, hospital-based providers, or collectors a default judgment without a responsible hospital officer's sworn statement. It must confirm that screening was offered before the lawsuit and the patient was found ineligible or did not respond. These rules take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
Charity care for specialty hospital patients
Hospitals providing only psychiatric, rehabilitation, or long-term acute care remain subject to separate charity-care duties under Delaware's facility-review rules. The Diamond State Hospital Cost Review Board sets who qualifies and how much charity care is required each fiscal year. The Department of Health and Social Services enforces these duties. These rules take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
Easier hospital aid applications for patients
Hospitals must post prominent assistance notices and explain help at registration or admission. They must offer screening and applications to uninsured patients, anyone paying part themselves, or patients owing at least $500 after insurance. Payment requests to those patients must include a notice and application; materials must cover languages spoken by more than 5% of the service area, using the latest census. Patients can apply after failed screening or during collections, even after debt is sold, and reapply after income changes or added medical costs. Hospitals must help applicants, accept electronic, mailed, or in-person applications, and decide completed applications with written notice within 21 days. Patients can appeal and submit supporting documents; hospitals cannot demand unauthorized or unreasonable documents or use practices that delay or discourage access. When approval follows a debt sale or assignment, the hospital must tell the debt holder that the debt is invalid. These rules take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
Hospital aid follows patients between providers
Regular hospital assistance decisions last at least one year, with written notice of the eligibility category, income basis, and dates. Other hospitals and providers working within hospitals must accept a valid notice and give at least the required minimum help. Hospitals also must use Board-set rules to identify patients who qualify without a full application or extra verification. This streamlined approval lasts at least 180 days, and patients can apply to extend it to one year. These rules take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
Hospital aid protected during Medicaid reviews
Hospitals may coordinate Medicaid screening when reliable available information suggests the patient qualifies for coverage on the service date. They cannot deny or delay assistance because public coverage is possible without screening, reasonable enrollment help, and documented screening steps. Patients legally ineligible for that coverage cannot be required to undergo screening as a condition of assistance. Temporary assistance generally cannot remain provisional beyond 180 days after assistance eligibility is determined, unless a still-pending coverage application is documented. Hospitals must settle the account with written notice within 30 days after receiving a coverage decision and refund overpayments within 30 days. During that account review, hospitals cannot bill or send covered amounts to collections. These rules take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
More help with large hospital bills
Hospitals must cut patient bills by at least 50% when one episode's out-of-pocket hospital costs reach 10% of yearly household income. Those costs include health-plan deductibles; any hospital income limit must be at least 500% of the federal poverty level. Patients apply through the regular assistance process, and previously denied patients provide added documents supporting hardship. Hardship approval lasts one year, covers services during that year, and must be honored by providers working within hospitals. These rules take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
Refunds for patients wrongly denied aid
Hospitals must refund payments covered by assistance when required screening was missed or eligibility was wrongly denied using information available then. The refund includes the amount paid, reasonable costs of securing assistance, and interest at the Federal Reserve rate. If the debt was sold or referred to a collection agency, the hospital must tell that agency it is invalid. These rules take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
State oversight protects hospital aid promises
The Diamond State Hospital Cost Review Board sets standard applications, income-verification materials, and streamlined eligibility methods. Hospitals may request only information reasonably needed to verify income and household size; the Board must approve changes that reduce paperwork within its allowed categories. Hospitals report assistance outcomes, screening, decision times, and aid amounts annually; the Board sets reporting details and posts policies and reports within 30 days of receipt. Complaints, unusual reporting patterns, and other warning signs can trigger compliance reviews. The Board must report hospital violations to the Division of Health Care Quality, which may take licensing action. The Department of Health and Social Services may impose civil penalties, and the Attorney General may sue for harmed patients or groups. Assistance duties stay attached to the hospital license when ownership or operation changes. These rules take effect when the Board publishes notice of final implementing rules or July 1, 2027, whichever comes first.
Sponsors & Cosponsors
Sponsor
Marie Pinkney
Democratic • Senate
Cosponsors
Nnamdi O. Chukwuocha
Democratic • House
Daniel Cruce
Democratic • Senate
Kerri Evelyn Harris
Democratic • House
Melissa Minor-Brown
Democratic • House
Nicole Poore
Democratic • Senate
Bryan Townsend
Democratic • Senate
Roll Call Votes
No roll call votes available for this bill.
Actions Timeline
SS 1 for SB 13 - Signed by Governor
7/20/2026GovernorSS 1 for SB 13 - Passed By House. Votes: 27 YES 13 NO 1 ABSENT
6/23/2026HouseSS 1 for SB 13 - Reported Out of Committee (Health & Human Development) in House with 1 Favorable, 8 On Its Merits
6/18/2026HouseSS 1 for SB 13 - Assigned to Health & Human Development Committee in House
6/11/2026HouseSS 1 for SB 13 - Passed By Senate. Votes: 17 YES 3 NO 1 ABSENT
6/11/2026SenateSubstituted in Senate by SS 1 for SB 13
6/11/2026SenateReported Out of Committee (Health & Social Services) in Senate with 1 Favorable, 4 On Its Merits
5/20/2026SenateIntroduced and Assigned to Health & Social Services Committee in Senate
5/12/2026Senate
Bill Text
Current
5/12/2026
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