(a) Providers. — A group health plan and a health insurer offering group health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health-care provider who is acting within the scope of that provider's license or certification under applicable state law. This section shall not require that a group health plan or health insurer contract with any health-care provider willing to abide by the terms and conditions for participation established by the plan or insurer. Nothing in this section shall be construed as preventing a group health plan, a health insurer or the Commissioner from establishing varying reimbursement rates based on quality or performance measures.
(b) Individuals. — The provisions of § 1557 of the Patient Protection and Affordable Care Act (relating to nondiscrimination) [42 U.S.C. § 18116], as the law and its implementing regulations were in effect on January 1, 2018, apply with respect to a group health plan or health insurer offering group health insurance coverage.
Structure Delaware Code
Chapter 35. GROUP AND BLANKET HEALTH INSURANCE
Subchapter III. Provisions Applicable to Group and Blanket Health Insurance
§ 3552. Cancer screening tests.
§ 3553. Midwife services reimbursement.
§ 3555. Coverage of cancer monitoring tests.
§ 3555A. Equal reimbursement for oral and intravenous anticancer medication.
§ 3556. Obstetrical and gynecological coverage.
§ 3557. Child abuse or neglect — Group coverage.
§ 3558. Immunizations and preventive services.
§ 3559. Contraceptive coverage.
§ 3560. Insurance coverage for diabetes.
§ 3560A. Cost sharing in prescription insulin drugs.
§ 3560B. Coverage for insulin pumps.
§ 3561. Annual pap smear coverage reimbursement.
§ 3562. Colorectal cancer screening.
§ 3563. Required coverage for reconstructive surgery following mastectomy.
§ 3565A. Required coverage for volunteer ambulance company services.
§ 3566. Prescription medication.
§ 3567B. Experimental treatment coverage.
§ 3568. Newborn and infant hearing screening; coverage and reimbursement.
§ 3569. Use of Social Security numbers on insurance cards.
§ 3570A. Autism spectrum disorders coverage.
§ 3571. Phenylketonuria (PKU) and other inherited metabolic diseases.
§ 3571A. Hearing aid coverage.
§ 3571B. Required coverage for scalp hair prosthesis.
§ 3571C. Dental services for children with a severe disability.
§ 3571D. Screening of infants and toddlers for developmental delays.
§ 3571E. Reimbursement for orthotic and prosthetic services.
§ 3571G. School-based health centers.
§ 3571H. Payment for emergency medical services.
§ 3571P. Rating factors [For application of this section, see 79 Del. Laws, c. 99, § 19].
§ 3571R. Telehealth and telemedicine.
§ 3571S. Network disclosure and transparency.
§ 3571U. Mental Health Parity and Addiction Equity Act reporting requirements.
§ 3571V. Time of submitting claim for reimbursement.
§ 3571W. Electronic medical claims.
§ 3571X. Medication assisted treatment for drug and alcohol dependencies.
§ 3571Y. Coverage for epinephrine autoinjectors.
§ 3571Z. Annual behavioral health well check [Effective Jan. 1, 2024].