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SPONSOR: Sen. Townsend & Sen. Hansen & Rep. Chukwuocha &
Rep. Bush
Sens. Buckson, Hoffner, Huxtable, Lawson, Pettyjohn,
Pinkney, Walsh, Wilson; Reps. Berry, Gorman, Hilovsky,
K. Johnson, S. Moore, Morrison, Snyder-Hall,
K. Williams, Yearick
DELAWARE STATE SENATE
153rd GENERAL ASSEMBLY
SENATE BILL NO. 238
AN ACT TO AMEND TITLE 24, TITLE 29, AND TITLE 31 OF THE DELAWARE CODE RELATING TO
INSURANCE COVERAGE FOR CHIROPRACTIC THERAPY AND PHYSICAL THERAPY.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:
1 Section 1. Amend § 716, Title 24 of the Delaware Code by making deletions as shown by strike through and
2 insertions as shown by underline as follows:
3 § 716. Chiropractors eligible for compensation from insurance; reimbursement at Medicare rate or comparable.
4 (a) (1) For purposes of disability insurance, standard health and accident, sickness, and all other such insurance
5 plans, whether or not they are considered insurance policies, and contracts issued by health service corporations and health
6 maintenance organizations, if the chiropractor is authorized by law to perform a particular service, all of the following
7 apply:
8 a. The chiropractor is entitled to compensation for that chiropractor’s services under the plan or contract.
9 b. The plan or contract may not have annual or lifetime numerical limits on chiropractic visits for the
10 treatment of back pain. the spine and other neuromusculoskeletal structures, including extremities.
11 Section 2. Amend § 2621, Title 24 of the Delaware Code by making deletions as shown by strike through and
12 insertions as shown by underline as follows:
13 § 2621. Physical therapists eligible for compensation from insurance.
14 (a) For purposes of disability insurance, standard health and accident, sickness, and all other such insurance plans,
15 whether or not they are considered insurance policies, and contracts issued by health service corporations and health
16 maintenance organizations, if a physical therapist is authorized by law to perform a particular service, the physical therapist
17 is entitled to compensation for that physical therapist’s services under such plans and contracts, and such plans and
18 contracts may not have annual or lifetime numerical limits on physical therapy visits for the treatment of back pain.
19 the spine and other neuromusculoskeletal structures, including extremities.
20 Section 3. Amend § 5203, Title 29 of the Delaware Code by making deletions as shown by strike through and
21 insertions as shown by underline as follows: Page 1 of 3 Released: 02/19/2026 09:10 AM
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22 § 5203. Specifications of the coverage.
23 (d) The plan may not place any annual or lifetime numerical limitations on physical therapy or chiropractic care
24 visits for the purpose of treating back pain. the spine and other neuromusculoskeletal structures, including extremities.
25 Section 4. Amend § 503, Title 31 of the Delaware Code by making deletions as shown by strike through and
26 insertions as shown by underline as follows:
27 § 503. Eligibility for assistance; amount; method of payment.
28 (b) Medicaid. — (1) Medical assistance may be granted to medically and financially eligible persons in
29 accordance with Titles IV-A, IV-E, XVI, and XIX of the Social Security Act (42 U.S.C. §§ 601 et seq., 1381 et seq., and
30 1396 et seq.), federally approved waivers of these sections of the act, and rules and regulations established by the
31 Department of Health and Social Services. Eligibility for and payment of medical assistance must be determined under
32 policies and regulations established by the Department of Health and Social Services. Eligibility standards, recipient copay,
33 and provider reimbursement must be set in accordance with state and federal mandates, state and federal funding levels,
34 approved waivers, and rules and regulations established by the Department. Department of Health and Social Services. The
35 amount of assistance in each case of medical care must not duplicate any other coverage or payment made or available for
36 the costs of such health services and supplies. To the extent permitted by federal requirements, no annual or lifetime
37 numerical limitations may be placed on physical therapy or chiropractic care visits that are for the purpose of treating back
38 pain. the spine and other neuromusculoskeletal structures, including extremities.
39 Section 5. This Act applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or
40 reissued after December 31, 2026.
SYNOPSIS
In Delaware, all individual health insurance policies, all group and blanket health insurance policies, the State
employee health insurance plan, and Medicaid are required to cover chiropractic and physical therapy treatment for chronic
back pain without annual or lifetime numerical limits on physical therapy or chiropractic care visits. To evaluate the
effectiveness of this coverage requirement, the Patient Centered Care Subcommittee of the Addiction Action Committee,
under the Delaware Department of Health and Social Services, sent a survey to chiropractic therapy and physical therapy
providers in Delaware. Although the survey showed that the coverage requirement has improved treatment of chronic pain
patients, the survey also showed that the coverage requirement provides supportive chronic pain treatment for only the
thoracic region of the spine, which is the middle of the spine from the base of the neck to the bottom of the ribs, and the
lumbar region of the spine, which is the lower back. The treatment of chronic pain through chiropractic supportive care,
physical therapy, or both, can prevent a patient from requiring opioid pain medications or more expensive treatments, but
excluding vital areas of the spine and body from coverage may limit the effectiveness of chiropractic therapy and physical
therapy treatment and limits a chronic pain patient’s potential for improvement.
This Act encourages treatment of chronic pain patients without opioids by updating the required health insurance
coverage to prohibit annual or lifetime numerical visits on physical therapy or chiropractic care visits that are for the
purpose of treating the spine and other neuromusculoskeletal structures, including extremities.
The updated coverage required under this Act applies to all policies, contracts, or certificates issued, renewed,
modified, altered, amended, or reissued after December 31, 2026.
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This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative
Drafting Manual.
Author: Senator Townsend
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0321530032Every fact on this page links to its source, starting with the official bill record.