State Law

Title 18 Insurance-1400-1403 Managed Care Organizations

08/01/2023 Delaware Section 1403-10.0

Prohibited Practices

Anti-retaliation, Prohibited financial incentives

See bold sections below:

Prohibited Financial Incentives

10.1 An MCO shall not offer incentives to a participating provider to provide less than medically necessary services to an enrollee.


10.2 An MCO shall not penalize a participating provider because the provider, in good faith, reports to State authorities any act or practice by the MCO that jeopardizes patient health or welfare.

10.3 An MCO shall not engage in any other practices prohibited by applicable provisions of Title 18 of the Delaware Code and regulations promulgated thereunder.