All Health Insurance Carriers and Pharmacy Benefits Managers Doing Business in Delaware

TRINIDAD NAVARRO COMMISSIONER STATE OF DELAWARE DEPARTMENT OF INSURANCE DOMESTIC AND FOREIGN BULLETIN NO. 153 TO: ALL HEALTH INSURANCE CARRIERS AND PHARMACY BENEFITS MANAGERS DOING BUSINESS IN DELAWARE RE: DEPARTMENT EXPECTATIONS IN RESPONSE TO EMERGENCY ORDER BY THE BOARD OF PHARMACY AND PHARMACY CLOSURES DATED: July 3, 2025 The purpose of this Bulletin is to inform all health insurance carriers and pharmacy benefits managers (PBMs) of their obligations and the Department’s expectations as they relate to the Emergency Order issued by the Board of Pharmacy with the concurrence of the Secretary of State on July 1, 2025, which provides temporary regulatory flexibilities for pharmacy operations. Carriers and PBMs are expected to act in good faith to minimize disruptions in pharmacy services and adhere to the guidance outlined within this Bulletin. Background On May 5, 2025, Rite Aid commenced Chapter 11 bankruptcy proceedings, resulting in pharmacy closures nationwide, including numerous Rite Aid locations in Delaware. These closures will disrupt patient access to medications, making prescription transfers and pharmacy accommodations an urgent priority. The Department anticipates a significant increase in prescription transfer requests as displaced patients seek new pharmacies. Carriers and PBMs are reminded of their obligations under 18 Del. C. Chs. 73 and 33A, respectively, to ensure uninterrupted access to essential medications. To maintain continuity of care and prevent disruptions, the following measures should be adhered to: Emergency Prescription Coverage • One-time emergency refills of non-controlled medications dispensed under the Board of Pharmacy Emergency Order must be honored. • Coverage should extend to alternative verification methods (e.g., prescription records, pharmacy databases) when prescriber authorization is unavailable due to pharmacy closures. Prior Authorizations and Prescription Transfers • Carriers must streamline the prescription transfer process for patients moving from closed Rite Aid locations to new pharmacies. • Prior authorizations tied to a specific pharmacy should be automatically transferred to the patient’s new pharmacy without requiring reauthorization. • Specialty medications and controlled substances requiring prior authorization should be expedited to avoid treatment delays. • Any documentation requirements should not create undue hardship for pharmacies processing high patient volumes. NOTE: This Bulletin is intended solely for informational purposes. It is not intended to set forth legal rights, duties, or privileges, nor is it intended to provide legal advice. Readers should consult applicable statutes and rules and contact the Delaware Department of Insurance if additional information is needed. ♦INSURANCE.DELAWARE.GOV♦ 1351 W. NORTH ST., SUITE 101, DOVER, DELAWARE 19904-2465 (302) 674-7300 DOVER♦ (302) 259-7554 GEORGETOWN♦ (302) 577-5280 WILMINGTON Page | 2 Pharmacy Reimbursement and Network Adequacy (Title 18, Chapter 33A) • PBMs should ensure fair reimbursement rates for pharmacies absorbing displaced patients, preventing financial strain on independent and community pharmacies. • Adequate pharmacy networks must be maintained to prevent pharmacy deserts, particularly in rural and underserved areas. Consumer Protection and Transparency • Restrictive policies that steer patients toward specific pharmacies or mail-order services are prohibited under Delaware’s Pharmacy Access Act (Title 18, Chapter 73). • Carriers should notify affected policyholders about pharmacy closures and provide clear instructions on transferring prescriptions. • Carriers and PBMs should provide dedicated support methods (e.g., hotlines or web portals) to assist individuals navigating prescription transfers. Compliance & Enforcement • Measures specific to the Board of Pharmacy Emergency Order will remain in effect for 120 days from the issuance date unless extended or terminated by the Board with the concurrence of the Secretary of State. • The Department will monitor compliance with these provisions and issue further guidance if needed. Questions, comments, or requests for clarification about this Bulletin should be emailed to compliance@delaware.gov. This Bulletin shall be effective immediately and shall remain in effect unless withdrawn or superseded by subsequent law, regulation or bulletin. ______________________________________ Trinidad Navarro Delaware Insurance Commissioner