(Dover, DE – June 26, 2025) – The Delaware Pre-Authorization Reform Act of 2025 cleared its final hurdle on Wednesday and heads to Governor Matt Meyer’s desk.

The Delaware House of Representatives unanimously passed Senate Bill 12. The legislation, which would reform pre-authorization in Delaware by removing serious roadblocks to necessary healthcare services, passed the Delaware Senate in May. Additionally, nearly 50 leading health nonprofits, organizations, and provider offices signed onto a letter of support for the Delaware Pre-Authorization Reform Act of 2025.

Championed by Senator Bryan Townsend, Senator Nicole Poore, Rep. Krista Griffith, and House Speaker Melissa Minor-Brown, Senate Bill 12 would streamline pre-authorization requirements in Delaware, also known as prior authorization, to create a more efficient process that allows for better access to timely health services. Pre-authorization is a process by which providers are required to request approval from insurance plans for certain healthcare procedures or medications.

“When you are grappling with medical needs, the most defeating thing to hear is ‘you’re going to have to wait.’ Delaying or denying access to needed care is flat out wrong — and it puts unnecessary financial, physical, and emotional tolls on patients across our state. Pre-authorization reform is needed in Delaware so patients can have access to the health services they need when they need them — all while driving down health care costs. I’m grateful to work with my colleagues and health advocates to get this bill over the finish line this year,” said Senator Poore, Senate prime sponsor.

Pre-authorizations are problematic and burdensome for both patients and providers. A recent American Medical Association survey found that more than 90% of physicians report that pre-authorizations delayed necessary care for patients. About 80% of respondents reported that pre-authorizations can lead to patients abandoning treatment and nearly 1 in 4 physicians report that pre-authorizations have led to serious adverse events for patients in their care.

“Every day, physicians, nurses, and staff are pulled in too many directions when they are simply trying to do their job – provide the best care for patients. That can cause burnout, stress, and so much more. What we’ve done today is a long time coming, but we have been able to bring stakeholders together to address pre-authorization in a way that will ease burdens on physicians and reduce access challenges for patients,” said Senator Townsend, Senate prime sponsor and longtime champion of this issue.

The statistics related to pre-authorization are alarming, reiterated House prime sponsor, Rep. Krista Griffith.

“Bottom line: It’s unacceptable for red tape to get in the way of necessary medical care,” said Rep. Griffith. “This legislation will help ensure timely access to healthcare services and improve efficiency. Pre-authorization reform is a win-win for the healthcare system. I’m thrilled to see this on its way to becoming law.”

In addition to the issues for patients, administrative burdens of pre-authorizations place a strain on physicians and other healthcare practitioners. That same AMA survey suggested providers on average spend about two business days per week on pre-authorizations alone. That can lead to burnout and other challenges within a practice. More than 1 in 4 physicians report that prior authorizations are often or always denied.

“Access to quality care leads not only to improved health outcomes but a better quality of life. Pre-authorization reform will ensure patients have access to this care without delay. These collective efforts make the healthcare system stronger for everyone,” said Speaker Minor-Brown.

This legislation addresses pre-authorization in these important ways:

• Shortens the response time to review a provider’s pre-authorization request.
• Increases the length of time that an approved pre-authorization remains valid.
• Limits the number of pre-authorizations required for a single episode of care.
• Ensures that utilization review entities are available to make determinations beyond the typical workday and on weekends.
• Ensures prompt response to pre-authorization requests made for patient transfers to help patients who are no longer in need of acute hospital care to transition to a more appropriate care setting.

“If a patient needs a specific treatment or procedure, it doesn’t make sense to have them have to jump through hoops to get that care. We are grateful for this legislation which has been a long time coming. Together, we can make meaningful changes to healthcare access and quality across our state,” said Richard Henderson, MD, chair of the Medical Society of Delaware Government Affairs Committee.

“This legislation will remove red tape from resident’s health care experience and ensures that health care providers can focus on patients instead of paperwork,” shared Insurance Commissioner Trinidad Navarro. “For more than two years, our team at the Delaware Department of Insurance has engaged with patients, legislators, and dozens of stakeholders to develop and support meaningful Prior Authorization reform for our state, and we are grateful for its passage.”

“Here are the facts: Pre-authorizations are frustrating for both patients and providers. Delawareans deserve better. We’re so thankful to work with Senator Townsend, the Medical Society of Delaware, and our legislative colleagues on legislation to significantly improve this process which will help streamline access to care, address burnout, and lead to improved health outcomes,” said Brian Frazee, President & CEO of the Delaware Healthcare Association.

Senate Bill 12 was formerly Senate Bill 6, which was stricken and replaced due to a technical correction.

About the Medical Society of Delaware
The Medical Society of Delaware is one of the oldest institutions of its kind in the United States and rich in history. Founded in 1776 and incorporated on February 3, 1789, The Medical Society of Delaware continues its support of physicians in their vigor and spirit to advance the profession, which was the basis for its creation. Our Mission is “To guide, serve and support Delaware Physicians, promoting the practice and profession of medicine to enhance the health of our communities.”   

About the Delaware Healthcare Association
The Delaware Healthcare Association (DHA) was formed in 1967 and is a statewide trade and membership services organization that represents and serves hospitals, health systems, and related healthcare organizations in their role of providing a continuum of appropriate, cost-effective, quality care to improve the health of the people of Delaware. DHA’s mission is to provide policy and advocacy leadership in creating an excellent environment to support our members in helping every Delawarean to be as healthy as they can be.

####