State Overview: Delaware

State law or statute prohibits or limits the use of prior authorization for buprenorphine containing products by either the state Medicaid plan or private insurance companies.

Health benefit plans must cover a five-day emergency supply of medications for treatment of drug and alcohol dependencies, including medications for opioid use disorder and naloxone, without prior authorization. Del. Code Ann. tit. 18, §§ 3343(b)(2)(a)

Carriers may not impose prior authorization requirements on buprenorphine, naltrexone, naloxone and buprenorphine/ naloxone. Del. Code Ann. tit. 18, §§ 3571X(d)(1)

Medicaid plans must cover a 72-hour emergency supply of medications for the treatment of drug and alcohol dependencies, including medications for OUD and naloxone, without prior authorization. Del. Code Ann. tit. 31, § 525(b)(2)

Delaware credentials two types of addiction counselors. A Certified Alcohol and Drug Counselor requires at minimum a high school diploma and 6,000 hours of experience. A higher-level degree can substitute the number of hours (i.e. a person with a bachelor's degree needs 4,000 hours). A Licensed Chemical Dependency Professional requires a master's degree and 3,200 hours as a substance abuse counselor. Del. Code Ann. tit. 24, §3040 – §3045, Del. Admin. Code tit. 24 §3000, Delaware Certification Board and Delaware Board of Mental Health and Chemical Dependency Professionals Licensing

A licensed professional counselor of mental health are trained clinical counseling principles, methods or procedures including the diagnosis and treatment of mental and emotional disorders to assist individuals in achieving more effective personal and social adjustment. Del. Code Ann. tit. 24 §3031(4)

There are currently no statutory or regulatory standards for the certification of peer recovery support specialists. Instead, the state recognizes the certification process of peer recovery support specialists by a third-party, non-profit certification provider.

Full independent practice and prescriptive authority.

An APRN, including an NM, is granted full-practice and prescriptive authority upon the issuance of an APRN license. Advanced practice nursing is an expanded scope of nursing licensed as an independent licensed practitioner in a role and population focus approved by the Board of Nursing and includes the RN scope of practice. Del. Code Ann. tit. 24 §1935

Full independent practice and prescriptive authority.

An APRN, including an NP, is granted full-practice and prescriptive authority upon the issuance of an APRN license. Advanced practice nursing is an expanded scope of nursing licensed as an independent licensed practitioner in a role and population focus approved by the Board of Nursing and includes the RN scope of practice. Del. Code Ann. tit. 24 §1935

Health care providers (including NPs) may sign medical orders for scope of treatment. Del. Code tit. 16 §2501a

NPs are recognized in state policy as primary care providers. The NP designation is received after graduation from a master's program or from an accredited post-basic NP certificate program of at least one academic year in length in a nurse practitioner specialty such as acute care, adult, family, geriatric, pediatric or women's health, etc. Del. Admin. Code §24-1900.84

Full independent practice and prescriptive authority.

Delaware opted out of the CRNA federal supervision requirement in 2023.

An APRN, including a CRNA, is granted full practice and prescriptive authority upon the issuance of an APRN license. Advanced practice nursing is an expanded scope of nursing licensed as an independent licensed practitioner in a role and population focus approved by the Delaware Board of Nursing and includes the CRNA scope of practice. Del. Code Ann. §24-1935

Optometrists may only examine, diagnose and treat conditions of the visual system including the removal of foreign bodies. Del. Code. Ann. tit. 24, §2101(a)

Optometrists may only administer an epinephrine autoinjector for treatment of anaphylaxis. Del. Code. Ann. tit.24, §2101(a)(3)

Optometrists may prescribe Schedule III-V controlled substances and also Schedule II hydrocodone or hydrocodone combination medications. Del. Code. Ann. tit. 24, §2101(a)(3)

Delaware does not allow dental hygienists to practice with direct access.

Statute does not identify dental therapists as an oral health provider.

Delaware allows for the practice of teledentistry and private payer reimbursement of dental services provided through telehealth. Del. Code Ann. tit. 24 §1101, Del. Code Ann. tit. 18 §3370 and Del. Code Ann. tit. 18 §3571R

Delaware has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act allowed pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Delaware does not allow pharmacists to modify prescriptions.

A pharmacist must complete an approved training program related to dispensing and administering contraceptives under the standing order and dispense the contraceptive or dispense and administer the injectable hormonal contraceptive as soon as practicable after the pharmacist determines that the patient meets the requirements under the standing order. Del. Code Ann. tit. 16 §3003O

Delaware does not allow pharmacists to prescribe tobacco cessation aids.

Collaboration allowed with a physician for practice and prescriptive authority.

"Collaboration or "collaborating" means a process in which the physician who oversees patient services and the PA jointly contribute to the health care and medical evaluation and treatment or management of patients with each performing actions he or she is individually licensed for and has the education, training and experience to perform. The collaborating physician must be available for consultation with the PA during the time of the patient encounter with the PA, if necessary to provide advice on the ongoing care of the patient. Del. Code Ann. tit. 24, §1770A(2)

PA practice includes medical acts of diagnosis and the prescription of therapeutic drugs and treatments; and referral of patients to specialists as needed. This includes Schedule II-V controlled substances. Del. Code Ann. Tit. 24, §1773(a)(2)(d)-(e)

Statute limits the number of PAs a physician may supervise.

A collaborating physician may not at any given time collaborate with more than 4 PAs, unless a regulation of the board increases or decreases the number. Del. Code Ann. tit. 24 §1771(f) & (h)

Delaware does not currently have any provisions related to chart review or co-signatures.

Statute allows adaptable proximity.

The constant physical presence of the collaborating physician is not required on-site in the practice setting, provided that the collaborating physician is readily accessible by some form of electronic communication. Del. Code Ann. tit. 24 §1770A(2)

A physician assistant's scope of practice is determined between the PA and the collaborating physician. Del. Code Ann. tit. 24 §1771