Insights

Experimental Treatment Coverage


On June 13, 2018, Gov. Carney signed HS 1 into law. The new law prohibits group health policies from denying coverage for a National Coverage Determination Service on the basis that such service, item or treatment is experimental or investigational. National Coverage Determination Service is defined as a service, item or treatment which has been determined to be covered nationally by HHS for Medicare purposes. In other words, if a service has been determined to be an eligible expense under Medicare, a group health plan issued or renewed in DE cannot exclude coverage for that service based on the reason that it is experimental.

The law was effective upon the governor's approval.

HS 1 »
HHS Listing of National Coverage Determinations »