Statutes and Regulations
DHIN Regulations
To fulfill the requirements of its enabling legislation (Title 16, Chapter 103 of the Delaware Code), DHIN has published regulations on a number of topics. These regulations set forth, among other things, requirements associated with submitting data to and accessing data from DHIN:
Delaware Healthcare Claims Database Regulations
In addition to the services it performs with respect to clinical data, DHIN also hosts the Delaware Healthcare Claims Database (HCCD). In enabling the HCCD, the State of Delaware required certain insurance companies providing services in Delaware and to Delaware residents to submit claims information to DHIN’s HCCD, to be used to improve the quality and decrease the cost of care in Delaware. In addition to the enabling legislation (Title 16, Chapter 103, Subchapter II of the Delaware Code), the submission of data to DHIN for use in the HCCD and the use of data from the HCCD is governed by regulations:
Prior Authorization Reporting
In an effort to improve transparency in the preauthorization approval and decline rates by health plans, Delaware law (Title 18, Subchapter V of the Delaware Code) now requires the submission of prior authorization data to DHIN at least twice a year.
Health insurers, health-benefit plans and health-service corporations are required to report to DHIN de-identified statistics regarding preauthorization approvals, denials and appeals in the specified format [linked below] by January 31 and July 31 of each calendar year.
- Q&A from conference call with DHIN and the Department of Insurance (1/31/18)
- Pre-authorization reporting requirements and reporting spreadsheet