DE HB39

Requires health insurance policies with network providers to cover inadvertent out-of-network services at agreed-upon or negotiated rates, with arbitration by the Insurance Commissioner if rates cannot be agreed upon.

Defines inadvertent out-of-network services as covered services provided by out-of-network providers in in-network facilities, when in-network services are unavailable, or laboratory testing ordered by in-network providers but performed by out-of-network labs.

Prohibits balance billing of insured individuals when non-network providers deliver emergency care or inadvertent out-of-network services; the non-prevailing party in arbitration must reimburse arbitration expenses.

Requires insurers to pay non-network providers the highest allowable charge used during the prior 12-month period pending Insurance Commissioner determination of appropriate rates.

Applies to individual, group, and blanket health insurance policies delivered in Delaware, and requires the Insurance Commissioner to promulgate regulations ensuring carriers maintain adequate networks of primary care providers and specialists.