{"data":{"id":"us-de/18-del.-c.-3586","jurisdiction":"us-de","citation":"18 Del. C. § 3586","heading":"Effect and length of pre-authorization; limitation per episode of care [For application of this section, see 85 Del. Laws, c. 176, § 4].","body":"(a) A pre-authorization for pharmaceuticals shall be valid for 1 year from the date the health-care provider receives the pre-authorization, subject to confirmation of continued coverage and eligibility and to policy changes validly delivered as per § 3582 of this title and except as otherwise set by evidence-based treatment protocol.\n(b) A pre-authorization for a health-care service shall be valid for a period of time that is reasonable and customary for the specific service, but no less than 90 days, from the date the health-care provider receives the pre-authorization, subject to confirmation of continued coverage and eligibility and to policy changes validly delivered as per § 3582 of this title.\n(c) Limitation per episode of care. —\nAn insurer, health-benefit plan, or health-service corporation may not require more than 1 pre-authorization for an episode of care. Any new treatment or additional testing or procedures related or unrelated to the specific medical problem, condition, or illness being managed may require a separate pre-authorization.\n(d) Pre-authorization of other covered services in-network. —\nIf a utilization review entity gives pre-authorization of a health-care service as part of a group of services for which a bundled payment is charged, pre-authorization of all other covered health-care services provided by in-network providers included in the group is deemed to be approved.","path":["Title 18. Insurance Code","Insurance","CHAPTER 35. Group and Blanket Health Insurance","Subchapter V. Pre-Authorization Transparency"],"source_url":"https://delcode.delaware.gov/title18/c035/sc05/index.html#3586","current_through":"2026-08-10 (85 Del. Laws, c. 421, 424)","vintage":"","retrieved_at":"2026-09-05T23:02:24Z","sha256":"1d811794ee6f63ea8d10a7575cf4d10dcee3c3dc14ce879f00f825e9bfa4c486","source_id":"us-de","stale":true,"prev":"us-de/18-del.-c.-3585","next":"us-de/18-del.-c.-3587"},"notice":"GroundRules: Original legal text. Not legal advice."}