Second Leg of the

152nd General Assembly

February 27, 2024

Keeping Busy During Budget Sessions

The 152nd General Assembly is focused on budget hearings during the month of February, but MSD continues to advocate for our key priorities to be ready for the rest of a busy legislative session.


We are excited to bring back a physician presence in Legislative Hall. MSD has brought back this time-honored tradition for several reasons:

  • Physician presence in the hall during a critical time in health care
  • Access to legislators
  • Ability to testify (support/oppose) in person, guaranteeing MSD’s message is heard by the legislature.
  • Networking with other health care professionals


If you are interested in learning more about representing MSD at Legislative Hall, contact Lisa Gruss at


For an overview of bills, please see the bill chart.


Updates on Priority Legislative Topics

Prior Authorization Reform

MSD, along with the Delaware Healthcare Association (DHA), authored a bill to significantly reform the prior authorization process. SB 10, the "Delaware Pre-Authorization Reform Act of 2023," was introduced on June 8. In the off session, MSD led a working meeting with Senator Townsend, the bill sponsor and critical stakeholders to ensure language meets the needs of physicians and patients. Senator Townsend has requested MSD to collaborate with the payors to ensure the revised bill can be reintroduced in March. Our lobby team is working to set up these meetings. 


Primary Care Reform

Primary Care Reform remains a strategic priority for MSD. Our physicians have continued crucial conversations with Senator Townsend, the bill’s sponsor, in the off-season about concerns in the delays of implementation of SB 120. The Primary Care Reform Collaborative (PCRC) of the Delaware Health Care Commission (DHCC) have drafted a model based on a PM/PM amount with a Standard Quality Incentive (SQI) (E&M codes) and prospective Continuous Quality Incentive (CQI) (value-based care transformation) components, which was presented at a recent PCRC meeting this month. Physicians and stakeholders raised several questions about the model. In the meantime, MSD has drafted new streamlined enhancements to SB 120, which sunsets in 2025. These proposed enhancements have been approved internally by the Primary Care Subcommittee, Government Affairs Committee, and the Executive Board. MSD will be collaborating with key stakeholders over the next several months to discuss possible enhancements to SB 120. 


Educational Transparency

MSD met with Representative Minor-Brown in January to discuss next steps regarding Educational Transparency (Title Misappropriation) and what they would like to achieve through legislation in 2023. In Delaware, legislation exists regarding the use of the word “doctor” in the clinical setting. However, with the growth of the digital age and advertising, additional clarity is needed within the legislation to ensure transparency to the patient, as well as their safety. The bill sponsor has agreed to work with MSD regarding legislation to ensure clarity in the introduction of non-physician doctors to patients, as well as truthful and transparent advertising. However, non-physician degreed doctors would be able to continue to use their earned title. The MSD lobby team is collaborating with an expert in this area to craft language for this bill.


Physician Workforce

Physician workforce remains a key priority for MSD. MSD is working to build a repository of resources available in Delaware to support workforce initiatives. The Delaware Healthcare Commission held a retreat in November 2023 to discuss available data and next steps regarding these issues as it relates not only to physicians, but the entire health care workforce. Delaware Health Force is an effort to create a public-private partnership to gather and aggregate data on this critical topic. This initiative has made available dashboards for public viewing. One of the challenges with the current data is that is not reflective of actively practicing doctors. The DHCC is working with the Division of Professional Regulations to capture information upon re-licensing in the future around currently practicing physicians and their length of time they intend to practice in Delaware. MSD supports adding these questions to license renewal, pending additional state approvals.


MSD Related Resolutions

The MSD Council adopted several resolutions at its Annual Meetings related to current advocacy activity.

MSD Response to the Obesity Epidemic - A Chronic Disease (A-2023)

This resolution, adopted at the Annual Meeting of the Council in November 2023, acknowledges Obesity as a Chronic Disease and was introduced by Shalini Shah MD and Robert Varipapa MD. There are three resolves associated with this resolution:

RESOLVED, That the Medical Society of Delaware declare that obesity is a chronic medical disease;

RESOVLED, that the Medical Society of Delaware declare that obesity is an epidemic affecting the state; and

RESOLVED, That the Medical Society of Delaware advocates for resources including practice guidelines, payment assistance, legislative action, improved patient access to care, and other efforts to address this epidemic.


MSD physicians are working to address the third resolve. MSD is enthusiastic about tackling this chronic disease with a multi prong legislative approach, but is aware of the potential fiscal concerns. MSD is currently exploring potential bill sponsors, as well as researching evidence-based approaches to obesity and monitoring local and national approaches to the epidemic.


Gun Violence is a Public Health Crisis (A-2023)

This resolution, also adopted in November 2023, recognizes gun violence. This resolution, introduced by the MSD Gun Violence Workgroup, has 3 resolves:

RESOLVED, That the Medical Society of Delaware acknowledge and declare that gun-related violence is a public health crisis;

RESOLVED, That the Medical Society of Delaware support effective public health firearm injury reduction interventions such as community violence intervention programs, as well as clinically driven intervention, including counseling patients and families on safe firearm storage; and

RESOLVED, That the Medical Society of Delaware support legislation appropriately vetted by the Government Affairs Committee including, but not limited to, legislation that creates an application process to obtain a handgun-qualified purchaser permit to authorize the purchase of a handgun, prohibits selling or transferring a handgun to an individual unless the individual has a handgun-qualified purchaser permit, requires that an applicant complete a firearms training course within 5 years before date of application, and requires the Department of Safety and Homeland Security to develop and administer a firearms training voucher program for low-income residents.

Currently, there is a bill SS 1 for SB 2 in this session that updates the code related to deadly weapons. This act has multiple components including creating an application process, requiring an application to complete a firearms training course within 5 years of application, add limits on transfers and sales, among other new requirements for records and training. MSD will be doing a more thorough review of the bill’s elements to see how it aligns with the MSD resolution. 

Addressing Health Disparities in Food Allergy Prevention (A-2022)

At the Annul Meeting of the Council in November 2022, Sunjay Shah, MD; Randeep Kahlon, MD; and Sangita Modi, MD introduced this resolution that was adopted by the Council as submitted.

RESOLVED, that the Medical Society of Delaware supports efforts by the Delaware State Legislature to provide education to families on food allergy prevention and create access to infant-safe peanut and well-cooked egg protein for all infants.

HB 274 amends the Delaware code relating to insurance coverage of allergen introduction in dietary supplements for infants. This act would require all health insurance plans subject to requirements under Delaware law, including Medicaid, to provide coverage to infants under the age of 1, of at least 1 early peanut allergen introduction dietary supplement and at least 1 early egg allergen introduction dietary supplement. The cost would be no charge to the insured patients.


Other Updates

Medical Marijuana

HB 285 proposes to update the code related to Medical Marijuana. The proposed updates include removal the word “debilitating” and allowing physicians and other clinicians to determine if a patient has a condition appropriate for treatment with medical marijuana. It also allows certain patients to self-certify they have an appropriate condition. Certain conditions are still listed in the bill. MSD wrote a letter to both the House Health Committee and more recently, the Senate Health Committee, that some specified conditions, such as glaucoma, lack evidence-based data for use of medical marijuana as treatment. Additionally, the letters expressed concerns with older populations self-certifying due to a myriad of reasons. This bill has passed the House and is headed to the Senate Health Committee.

Alzheimer's Disease, Dementia Education

MSD met with Senator Mantzavinos, the bill sponsor for SB 283 (151st) and its sister bill, SB 185, related to continuing education for the “diagnosis, treatment, and care of patients with Alzheimer’s disease or other dementias” in late October. MSD made it clear that legislation regarding regular CME education is not the ideal pathway to improving patient care. MSD has a follow-up meeting scheduled with the sponsor on February 26th.

Increased Access to Mammograms

HB 253 is a bill that would update the Delaware Code relating to Mammograms. This Act’s goal is to increase access to mammograms for women 40 years of age and older. Although MSD applauds the bill sponsor, Representative Williams, for the initiative to make preventive care more accessible to all, the bill lacks details regarding follow-up to abnormal results and liability. MSD is collaborating with other stakeholders on this bill, including the American College of Radiology (ACR), to ensure that both the federal and local health care landscape is understood regarding access to mammograms and self-referrals. MSD and stakeholders are exploring the utilization of nurse navigators to support patients that do not have a physician of care as part of their self-referral.


Did you know?

The budget process is a year-long process. The end of January and the month of February is focused on budget hearings in Legislative Hall. The Joint Finance Committee (JFC) conducts public hearings on state agency operating budget requests for the next fiscal year, as presented in the Governor’s Recommended Budget. Therefore, this month they are reviewing requests for FY2025. The final budget will not be completed until June 2024.


The JFC is responsible for writing the annual operating budget and grant-in-aids. It is made up of 6 members of the Senate Finance Committee and 6 members of the House Appropriations Committee.  


For information on the hearings, briefings, and presentations, check out the Joint Finance page of the Delaware General Assembly website.

Contact Us 

For more details on specific legislation, or if you have other questions, please contact Mark B. Thompson, MHSA, Executive Director at 302-444-6958, or Lincoln Willis, lobbyist at 302-632-9898 or


MSD actively monitors all health-related legislation and maintains an active and visible presence in the Legislative Hall on your behalf.


The Medical Society of Delaware Legislative e-Updates are a benefit to our members, providing information on legislative activity of interest in the 152nd General Assembly in Dover.