Delaware Hospitals Debated New Charity Care Rules
Hospital leaders met with regulators to address upcoming mandatory income threshold changes for patient assistance.
Updated on Oct. 7, 2026 in Healthcare
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Delaware healthcare systems recently met with the Diamond State Hospital Cost Review Board to discuss the implementation of Senate Bill 13. This legislation mandates that hospitals provide free care to patients earning below 300% of the federal poverty line by January 1, 2027.
Why it matters
The mandate forces hospital systems to overhaul their financial assistance screening processes to accommodate a higher eligibility threshold. Leaders are currently working to balance these new state requirements with concerns regarding the potential for system misuse by ineligible applicants.
Delaware hospitals spent an average of $39 million annually on charity care from 2020 to 2024, representing 1% of total operating expenses. The new threshold for free care is set at 300% of the federal poverty line, currently defined as $47,880 in annual income.
The players
Diamond State Hospital Cost Review Board
A state-level regulatory body tasked with overseeing healthcare spending and enforcing hospital financial compliance in Delaware.
Senate Bill 13
State legislation that mandates expanded free hospital care eligibility for patients earning up to 300% of the federal poverty line.
The details
Under Senate Bill 13, hospitals must update their income thresholds to comply with the 300% federal poverty line mandate. During the October 5 meeting, administrators and regulators reviewed eligibility screening processes and tax return consolidation methods to ensure alignment. The Diamond State Hospital Cost Review Board is currently refining these enforcement mechanisms ahead of the 2027 implementation deadline.
Timeline
Annual charity care spending averaged $39 million between 2020 and 2024.
Hospital leaders met to discuss the new regulations on October 5, 2026.
Hospitals must update income thresholds by January 1, 2027.
The Diamond State Hospital Cost Review Board expects to finalize all regulations by February 2027.
Market Landscape
This regulatory update marks a formal shift in hospital financial policy driven by the requirements set forth in Senate Bill 13. The proceedings follow a trend of state-level intervention into hospital charity care ratios and eligibility definitions.
Hospital operators should begin re-evaluating their current financial assistance screening tools to ensure they can capture the expanded 300% federal poverty line demographic. Consult with legal counsel to ensure that internal audit processes for documentation meet the forthcoming state reporting standards.
The takeaway
The move toward a 300% federal poverty line threshold for charity care significantly changes the volume of patients qualifying for financial assistance in Delaware. Operators should prioritize training for billing staff and update patient-facing documentation to reflect these changes before the 2027 deadline.
What happens next
Hospitals must update their income thresholds to comply with the new charity care requirements no later than January 1, 2027. The Diamond State Hospital Cost Review Board is scheduled to finalize the formal regulations by February 2027.
Further reading
For broader insights on clinical compliance and state regulatory trends, see the Healthcare section.
Source note: This article includes information reported by Spotlight Delaware.
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