DelawareSB 213 w/ SA 1153rd General Assembly (2024–2026)SenateWALLET

AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO HOSPITAL BUDGET REVIEW.

Sponsored By: Bryan Townsend (Democratic)

Signed by Governor

Your PRIA Score

Score Hidden

Personalized for You

How does this bill affect your finances?

Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.

Free to start

Bill Overview

Analyzed Economic Effects

4 provisions identified: 0 benefits, 1 costs, 3 mixed.

Benchmark plans and backup budget control

Beginning in 2027, the Board can require a plan within 45 days when a hospital’s cost growth beats the benchmark. Hospitals in a qualifying Meaningful Cost Containment Arrangement are exempt for that year. Plans must explain causes, set measurable steps, and finish within 12 months; if rejected, resubmit in 30 days. The Board may add reporting and will check results. If a plan fails or is not acceptable, the hospital must submit next year’s budget for approval 90 days before the fiscal year. The Board cannot change a budget if growth is at or below the benchmark; it may adjust for unusual needs, and hospitals that meet goals three straight years can exit approval.

Penalties and voting rules for oversight

The Board may fine a hospital up to $500,000 for knowing noncompliance after notice and a chance to be heard. Four voting members make a quorum. A majority of all voting members must approve budgets, enforcement, regulations, findings, and plans.

More hospital reporting and hearings

The Board sets a schedule and a single Uniform Reporting Manual for hospital budgets. Each year, hospitals must file next year’s budget with redlines and detailed finance, labor, and service data. They must also submit audited financial statements within 30 days of finalization, starting with 2023 audits. The Board meets with each hospital, reviews spending, staffing investments, and disclosed leadership salaries, and issues written findings and any MCCA status. The Board holds at least one public hearing per hospital each year so people can see and comment on plans and costs.

New rules for hospital cost-control deals

The law defines Meaningful Cost Containment Arrangements for a plan year. A Medicare or Medicaid global budget deal must cover at least 50% of past patient volume and put at least 3% of net patient revenue at risk. A downside‑risk deal must cover total annual costs of at least 3% of net patient revenue, put at least 10% of those costs at risk, and, for hospitals with budgets over $1,000,000,000, cover at least 5,000 lives. The Board can raise these thresholds by rule and defines “total annual costs” for these checks. These deals can qualify a hospital as a Meaningful Cost Containment Arrangement for that year.

Sponsors & Cosponsors

Sponsor

Bryan Townsend
Democratic • Senate

Cosponsors

Kerri Evelyn Harris
Democratic • House
S. Elizabeth Lockman
Democratic • Senate
Melissa Minor-Brown
Democratic • House
Edward S. Osienski
Democratic • House
David P. Sokola
Democratic • Senate

Roll Call Votes

All Roll Calls

Yes: 54 • No: 7

House vote • 1/29/2026

Passed (SM required)

Yes: 33 • No: 7

Senate vote • 1/20/2026