State Tracker Updated June 15, 2026

Delaware: what the PBM reimbursement law requires

Delaware requires MAC transparency, a 10-day MAC appeal process with escalation to the Insurance Commissioner, and anti-self-dealing payment parity, and lets pharmacies decline to dispense below acquisition cost — but it does not set a reimbursement floor.

Status	Partially enacted
Law	18 Del. C. §§ 3323A–3325A (HB 219, 2021)
Effective date	October 26, 2021
Reimbursement basis	No reimbursement floor. PBMs must keep transparent MAC lists, may not pay a pharmacy less than they pay an affiliate for the same goods or services (anti-self-dealing parity), and a pharmacy may decline to dispense when reimbursement is below its acquisition cost — a right to refuse, not a payment mandate.
Professional dispensing fee	Not specified in statute (dispensing fees must be excluded from the MAC calculation)
Appeal route	Pharmacy has 10 calendar days from the fill date to appeal; PBM responds within 10 calendar days; denials can be escalated to the Insurance Commissioner

Delaware’s PBM law (18 Del. C. §§ 3323A–3325A, as amended in 2021) centers on transparency, appeals, and self-dealing rather than a reimbursement floor. PBMs must build MAC lists with dispensing fees excluded, give pharmacies a 10-day appeal when reimbursement falls below what the pharmacy paid its supplier, and may escalate unresolved disputes to the Insurance Commissioner.

The statute also bars a PBM from paying a pharmacy less than it pays its own affiliate for the same goods or services, and lets a pharmacy decline to dispense below acquisition cost. It does not, however, require the PBM to pay at or above NADAC or acquisition cost in the first place.

Sources

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