Bifurcated

Delaware No Surprises Act & IDR Rules

Last verified: July 2026 · For informational purposes only, not legal advice

Quick answer: Delaware is a bifurcated state. Some disputes are governed by Delaware's own specified state law, while others default to the federal No Surprises Act IDR process depending on the plan type and service involved.

How it works

Delaware's specified state law applies to emergency services originating at a hospital emergency facility or comparable facility from non-network providers. The federal IDR process applies to non-emergency items and services by out-of-network providers at in-network facilities, plus air ambulance services.

Key dates

Federal No Surprises Act protections took effect January 1, 2022. State-specific protections vary — check the official source below for exact effective dates in this state.

Official source: Centers for Medicare & Medicaid Services — Delaware enforcement letter and specified state law documentation (cms.gov/nosurprises)

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