Delaware Hospitals to Screen All Balances Over $500
Nonprofit hospitals must implement standardized charity care checks to comply with new state regulatory requirements.
Updated on Oct. 21, 2026 in Philanthropy
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The Diamond State Hospital Cost Review Board has moved toward finalizing new charity care regulations for the state's nonprofit hospitals. Under these rules, hospitals will be required to screen all patients with balances exceeding $500 for eligibility for free or discounted medical services.
Why it matters
These regulations enforce Senate Bill 13, which aims to standardize patient access to affordable care across all six of Delaware's hospital systems. Operators and healthcare administrators must prepare for new audit requirements and stricter reporting on eligibility determination times.
Proposed regulations mandate charity care screening for any patient balance exceeding $500. This follows Senate Bill 13, which sets full charity care eligibility for those below 300% of the federal poverty line and graduated discounts for those up to 500%.
The players
Diamond State Hospital Cost Review Board
A state regulatory body tasked with overseeing nonprofit hospital pricing and charity care compliance.
Delaware Division of Health Care Quality
The state agency responsible for the enforcement of healthcare standards and regulatory violations.
The details
The board plans to implement periodic outside audits to scrutinize hospital denial rates and the time taken to determine patient eligibility. Hospitals are now required to screen both insured and uninsured patients for these programs. Credible complaints regarding noncompliance will be referred to the Delaware Division of Health Care Quality for investigation.
Timeline
Senate Bill 13 was signed into law in Summer 2026.
The board met on October 20, 2026, to review the draft regulations.
Hospital systems are scheduled to present information to the board in November 2026.
The board will hold its next meeting on November 17, 2026.
Market Landscape
These draft regulations represent the formal implementation phase of Delaware Senate Bill 13. The process establishes a new compliance standard for nonprofit hospital systems that prioritizes standardized charity care across the state.
Healthcare operators must immediately update their patient intake and billing software to automate screenings for all balances over $500. Ensure financial records align with the new federal poverty line tiers to avoid potential investigation by the Delaware Division of Health Care Quality.
The takeaway
The move toward mandatory screening thresholds signals that regulators are prioritizing consistent patient access over internal hospital discretion. Administrators should audit their current determination wait times to ensure they meet the upcoming state expectations before the next board hearing.
What happens next
Hospital systems must present detailed operational information to the Diamond State Hospital Cost Review Board in November 2026, followed by a public meeting on November 17, 2026.
Further reading
For broader context on local efforts, see Delaware Philanthropy.
Source note: This article includes information reported by Spotlight Delaware.
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