# 18 Del. C. § 3587: § Â 3587. Electronic standards for pre-authorization [For application of this section, see 85 Del. Laws, c. 176, Â 4]

> Delaware · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3587

## Section

- **Citation:** 18 Del. C. § 3587
- **Heading:** § Â 3587. Electronic standards for pre-authorization [For application of this section, see 85 Del. Laws, c. 176, Â 4]
- **Jurisdiction:** Delaware
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Delaware Code / Title 18 / Chapter 35 / Subchapter V / Section 3587

## Text

(a) No later than January 1, 2018, the insurer must accept and respond to pre-authorization requests under the pharmacy benefit through a secure electronic transmission using the NCPDP SCRIPT standard ePA transactions. Facsimile, proprietary payer portals, and electronic forms shall not be considered electronic transmission.

(b) No later than January 1, 2027, an insurer, health-benefit plan, health-service corporation, or utilization review entity must allow for and accept electronic pre-authorization requests and must respond to electronic pre-authorization requests through the same website, mobile application, digital platform, or other method as the electronic pre-authorization request was submitted.

(c) No later than January 1, 2027, an insurer, health-benefit plan, health-service corporation, or utilization review entity must establish a provider portal that includes all of the following features:

(1) Electronic submission of pre-authorization requests.

(2) Access to the insurer’s, health-benefit plan’s, health-service corporation’s, or utilization review entity’s applicable medical policies.

(3) Information necessary to request a peer-to-peer review.

(4) Contact information for the insurer’s, health-benefit plan’s, health-service corporation’s, or utilization review entity’s relevant clinical or administrative staff.

(5) For any health-care service that requires pre-authorization that is not subject to electronic submission via the provider portal, copies of applicable forms.

(6) Instructions for the submission of pre-authorization requests if the insurer’s, health-benefit plan’s, health-service corporation’s, or utilization review entity’s provider portal is unavailable for any reason.

(d) Within 12 months following establishment of a provider portal under subsection (c) of this section, the insurer, health-benefit plan, health-service corporation, or utilization review entity may require a health-care provider seeking pre-authorization to submit the request via the provider portal unless 1 of the following exemptions applies:

(1) The portal is not available and operational at the time of attempted submission.

(2) The health-care provider does not have access to the insurer’s, health-benefit plan’s, health service corporation’s, or utilization review entity’s operational provider portal.

(3) The health-care provider satisfies an allowance by the insurer, health-benefit plan, health service corporation, or utilization review entity for submission other than through the provider portal.

## Nearby sections

- [18 Del. C. § 3581 § Â
        3581. Definitions [For application of this section, see 82 Del. Laws, c. 44, Â 3; 85 Del. Laws, c. 176, Â 4].](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3581.md)
- [18 Del. C. § 3582 § Â
        3582. Disclosure and review of pre-authorization requirements; adverse determinations. [For application of this section, see 85 Del. Laws, c. 176, Â 4].](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3582.md)
- [18 Del. C. § 3583 § Â
        3583. Utilization review entityâs obligations with respect to pre-authorizations [For application of this section, see 85 Del. Laws, c. 176, Â 4].](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3583.md)
- [18 Del. C. § 3584 § Â
        3584. Utilization review entityâs obligations with respect to pre-authorization concerning emergency health-care services.](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3584.md)
- [18 Del. C. § 3585 § Â
        3585. Retrospective denial.](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3585.md)
- [18 Del. C. § 3586 § Â
        3586. Effect and length of pre-authorization; limitation per episode of care [For application of this section, see 85 Del. Laws, c. 176, Â 4].](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3586.md)
- [18 Del. C. § 3587 § Â
        3587. Electronic standards for pre-authorization [For application of this section, see 85 Del. Laws, c. 176, Â 4].](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3587.md)
- [18 Del. C. § 3588 § Â
        3588. Health-care services deemed preauthorized if a utilization review entity fails to comply with the requirements of this subchapter.](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3588.md)
- [18 Del. C. § 3589 § Â
        3589. Waiver prohibited.](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3589.md)
- [18 Del. C. § 3590 § Â
        3590. Exemptions.](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3590.md)
- [18 Del. C. § 3591 § Â
        3591. Step therapy exception process [For application of this section, see 82 Del. Laws, c. 44, Â 3].](https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3591.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_DE_T18_C35_SV_S3587. Check the current official text before relying on it. Not legal advice.
