Delaware § 5224 - Primary care coverage.

§ 5224. Primary care coverage.

The plan shall do all of the following:

(1) Provide coverage in compliance with § 5204(c) of this title.

(2) Exclude certain high-cost claims in calculating the total cost of medical care for purposes of this section, as authorized by the State Employee Benefits Committee.

(3) Report data to the Office of Value-Based Health Care Delivery on high-cost claims and on the percentage of primary care spending as a percentage of total medical costs for plan year 2027 by July 1, 2029, and for plan year 2028 by July 1, 2030.

(4) In plan year 2029, increase primary care spending by 1% from the higher of the 2 prior plan years.

(5) In plan years 2030, 2031, and additional plan years as necessary, increase primary care spending by 1% until primary care spending reaches 11.5% of total medical costs.

(6) Spend at least 11.5% of total cost of medical care on primary care each plan year thereafter.

85 Del. Laws, c. 348, § 10;