Delaware · 153rd General Assembly (2025-2026) · Bill
HB 212: AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO OVERPAYMENT RECOVERY AND AUDIT PRACTICES.
Enacted Official data
- Introduced
- In committee
- Passed one chamber
- Passed both chambers
- Enacted
Last official action: ·Record last updated:
Plain-language summary
HB 212 is a bill introduced in the Delaware House on June 18, 2025. According to its official title, it concerns: AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO OVERPAYMENT RECOVERY AND AUDIT PRACTICES. Primary sponsor: Bill Bush (Democratic), Spiros Mantzavinos (Democratic), Bryan Townsend (Democratic). It lists 5 additional sponsors. Most recent recorded action (September 3, 2025): Signed by Governor.
Generated automatically from the official title, sponsor list, and status record only. It does not characterize the bill’s purpose or effects. How summaries are written
Official summary
Abstract published by the legislature (via Open States). Text as published by the legislature; reproduced verbatim.
This Substitute for House Bill No. 212 corrects a technical drafting error to underline new language contained in Section 2 of the Act, and is otherwise identical to House Bill No. 212, which does the following: Section 1 of this Act amends the time period during which health insurers may initiate overpayment recovery efforts from 24 months to 12 months of a claim being paid. This Act also amends one of the exemptions to the overpayment recovery deadline to require an indication of fraud, abuse, or other intentional misconduct based on a physical review or review of claims data or statements as opposed to merely having a reasonable belief of such fraud, abuse or other intentional misconduct. It aligns requirements for provider-oriented clawbacks with those for pharmacies. Section 2 of this Act requires written notice from pharmacy benefit managers or entities conducting pharmacy audits. Because Department examinations have indicated that PBMs misuse this provision in the law to conduct audits outside the parameters of the Pharmacy Audit Integrity Program, Section 3 of this Act amends the exclusions to the applicability of the pharmacy audit rules to require that pharmacy benefits managers have more definitive proof, based on physical review of claims data or other investigative methods, to believe misconduct has occurred before the rules related to the Pharmacy Audit Integrity Program become inapplicable to an investigative audit. This Act also makes technical corrections to existing law to conform to the requirements of the Delaware Legislative Drafting Manual.
Sponsors
Sponsors by party (alphabetical): Democratic 7 · Republican 1
| Name | Role | Party | Chamber | District |
|---|---|---|---|---|
| Bill Bush | Primary sponsor | Democratic | House | 29 |
| Spiros Mantzavinos | Primary sponsor | Democratic | Senate | 7 |
| Bryan Townsend | Primary sponsor | Democratic | Senate | 11 |
| Stephanie Bolden | Co-sponsor | Democratic | House | 2 |
| Larry Lambert | Co-sponsor | Democratic | House | 7 |
| Nicole Poore | Co-sponsor | Democratic | Senate | 12 |
| Claire Snyder-Hall | Co-sponsor | Democratic | House | 14 |
| Dave Wilson | Co-sponsor | Republican | Senate | 18 |
“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.
Recent official actions
- Signed by Governor
- Passed By Senate. Votes: 21 YES
- Reported Out of Committee (Banking, Business, Insurance & Technology) in Senate with 7 On Its Merits
- Assigned to Banking, Business, Insurance & Technology Committee in Senate
- Passed By House. Votes: 40 YES 1 VACANT
- was introduced and adopted in lieu of HB 212