(a) No individual policy or contract of health insurance, or certificate issued thereunder, which is delivered, issued for delivery, or renewed in this State by any health insurer, health service corporation, or health maintenance organization shall deny coverage, payment, or reimbursement for a National Coverage Determination Service on the basis that the service, item, test, or treatment is experimental or investigational.
(b) “National Coverage Determination Service” as used in this section shall mean a service, item, test, or treatment which has been determined to be covered nationally by the Secretary of the U.S. Department of Health and Human Services pursuant to the Social Security Act, § 1869 (f) [42 U.S.C. § 1395ff].
Structure Delaware Code
Chapter 33. HEALTH INSURANCE CONTRACTS
Subchapter I. General Provisions
§ 3303. Scope, format of policy [For application of this section, see 79 Del. Laws, c. 99, § 19].
§ 3304. Required provisions; captions; omissions; substitutions.
§ 3305. Entire contract; changes.
§ 3306. Time limit on certain defenses.
§ 3312. Time of payment of claims.
§ 3314. Physical examination; autopsy.
§ 3316. Change of beneficiary.
§ 3317. Optional policy provisions.
§ 3320. Overinsurance; all coverages.
§ 3321. Relation of earnings to insurance.
§ 3323. Conformity with state statutes.
§ 3325. Intoxicants and narcotics.
§ 3327. Order of certain provisions.
§ 3328. Third-party ownership.
§ 3329. Requirements of other jurisdictions.
§ 3330. Policies issued for delivery in another state.
§ 3331. Conforming to statute.
§ 3334. Franchise health insurance law.
§ 3336. Midwife services reimbursement.
§ 3338. Coverage of cancer monitoring test.
§ 3338A. Equal reimbursement for oral and intravenous anticancer medication.
§ 3340. Child abuse or neglect — Individual coverage.
§ 3341. Newborns and mothers health protection.
§ 3342. Obstetrical and gynecological coverage.
§ 3342A. Contraceptive coverage.
§ 3344. Insurance coverage for diabetes.
§ 3344B. Cost sharing in prescription insulin drugs.
§ 3344C. Coverage for insulin pumps.
§ 3345. Annual pap smear coverage reimbursement.
§ 3346. Colorectal cancer screening.
§ 3347. Required coverage for reconstructive surgery following mastectomies.
§ 3349A. Required coverage for volunteer ambulance company services.
§ 3350. Prescription medication.
§ 3351B. Experimental treatment coverage.
§ 3352. Newborn and infant hearing screening; coverage and reimbursement.
§ 3353. Use of social security numbers on insurance cards.
§ 3355. Phenylketonuria (PKU) and other inherited metabolic diseases.
§ 3356. Required coverage for scalp hair prosthesis.
§ 3358. Dental services for children with a severe disability.
§ 3359. Health insurance; pharmacies; electronic reimbursement.
§ 3359B. Electronic medical (non-pharmaceutical) claims.
§ 3360. Screening of infants and toddlers for developmental delays.
§ 3362. Reimbursement for orthotic and prosthetic services.
§ 3363. Recommended immunizations.
§ 3364. Specialty tier prescription coverage.
§ 3365. School-based health centers.
§ 3366. Autism spectrum disorders coverage.
§ 3367. Payment for emergency medical services.
§ 3370. Telehealth and telemedicine.
§ 3370A. Network disclosure and transparency.
§ 3370C. Time of submitting claim for reimbursement.
§ 3370D. Coverage for epinephrine autoinjectors.
§ 3370E. Annual behavioral health well check [Effective Jan. 1, 2024].