Hawaii 2022 Regular Session

Hawaii Senate Bill SCR239 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	THE SENATE S.C.R. NO. 239 THIRTY-FIRST LEGISLATURE, 2022 STATE OF HAWAII SENATE CONCURRENT RESOLUTION requesting the legislative reference bureau to conduct a financial analysis of the managed care organizations that administer the employeR-union health benefits trust fund by auditing the amounts paid for health care and amounts paid for administrative services.
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3	3	THE SENATE S.C.R. NO. 239
4	4	THIRTY-FIRST LEGISLATURE, 2022
5	5	STATE OF HAWAII
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7	7	THE SENATE
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9	9	S.C.R. NO.
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11	11	239
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13	13	THIRTY-FIRST LEGISLATURE, 2022
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17	17	STATE OF HAWAII
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29	29	SENATE CONCURRENT
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31	31	RESOLUTION
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37	37	requesting the legislative reference bureau to conduct a financial analysis of the managed care organizations that administer the employeR-union health benefits trust fund by auditing the amounts paid for health care and amounts paid for administrative services.
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45	45	WHEREAS, Hawaii has long been a leader in advancing medical services and health care, advocating the importance of access to health care without discrimination, and implementing forward-thinking health care policies, such as the Prepaid Health Care Act of 1974; and WHEREAS, it is in the best interest of the State for every Employer-Union Health Benefits Trust Fund beneficiary to have publicly provided, high-quality, and affordable health care; and WHEREAS, health care involves more than just medical insurance payouts and also includes cost-saving preventive and early intervention measures, dental coverage, and mental illness treatment to prevent medical health conditions from becoming chronic, permanently disabling, or fatal; and WHEREAS, under Hawaii's existing health care insurance system, health insurance companies have used their unilateral control over how health care is organized and paid for to erect obstacles to care for patients through excessive prior authorizations, formulary restrictions, and networks with limited physician participation; and WHEREAS, this system also burdens physicians and hospitals with administrative demands, such as pay for performance, pay for documentation, and capitation, all of which require much more detailed documentation and data reporting while controlling and restricting payment for primary care in particular, which results in physicians being driven out of practice or leaving the State; and WHEREAS, health care rates are skyrocketing, creating an affordability and accessibility crisis for Hawaii's residents; and WHEREAS, the two largest cost drivers of health care in the United States and Hawaii are: (1) High administrative costs due to reliance on a competitive insurance business model that incentivizes denial and obstruction of care, micromanagement of doctors and hospitals, and attempts to avoid covering or paying for sicker and socially disadvantaged patients and populations, resulting in disparities in access to care; and (2) The high cost of prescription drugs; and WHEREAS, for more than a quarter of a century, Hawaii was far ahead of most other states, often calling itself the "Health State" because of the Hawaii Prepaid Health Care Act of 1974, and was once known for having a low percentage of residents without health insurance, which was between two and five percent in 1994; and WHEREAS, as a result of the coronavirus disease 2019 pandemic, thousands of Hawaii residents have lost their jobs and health insurance, making it critical for the State to support struggling families by ensuring preventive care and limiting out-of-pocket costs; and WHEREAS, the safeguarding of access to health care, solidification of the essential health benefits that have changed thousands of lives, and improvement of overall access to care requires the preservation of certain important aspects of the federal Patient Protection and Affordable Care Act and the expansion of access to care for residents of Hawaii; and WHEREAS, negotiations between the health insurance industry and the Obama Administration in 2011 allowed health insurance plans to reclassify "medical management" costs as health care instead of administrative costs for the purposes of reporting medical loss ratios, enabling large administrative costs to be hidden; now, therefore, BE IT RESOLVED by the Senate of the Thirty-first Legislature of the State of Hawaii, Regular Session of 2022, the House of Representatives concurring, that the Legislative Reference Bureau is requested to conduct a financial analysis of the managed care organizations that administer the Employer-Union Health Benefits Trust Fund by auditing the amounts paid for health care and amounts paid for administrative services; and BE IT FURTHER RESOLVED that in its financial analysis, the Legislature Reference Bureau is requested to: (1) Conduct an analysis of the effects of payment reforms and payment of primary care physicians with capitation on practice administrative costs and burdens and their contributions to Hawaii's physician shortage; (2) Analyze "medical management" administrative costs and the administrative cost of payment reforms from payments to providers for provision of health care; and (3) Investigate other issues it deems relevant; and BE IT FURTHER RESOLVED that the Legislative Reference Bureau is requested to submit a report of its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2023; and BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of the Legislative Reference Bureau and Administrator of the Hawaii Employer-Union Health Benefits Trust Fund. OFFERED BY: _____________________________ Report Title: Legislative Reference Bureau; Employer-Union Health Benefits Trust Fund; Financial Analysis
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47	47	WHEREAS, Hawaii has long been a leader in advancing medical services and health care, advocating the importance of access to health care without discrimination, and implementing forward-thinking health care policies, such as the Prepaid Health Care Act of 1974; and
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51	51	WHEREAS, it is in the best interest of the State for every Employer-Union Health Benefits Trust Fund beneficiary to have publicly provided, high-quality, and affordable health care; and
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55	55	WHEREAS, health care involves more than just medical insurance payouts and also includes cost-saving preventive and early intervention measures, dental coverage, and mental illness treatment to prevent medical health conditions from becoming chronic, permanently disabling, or fatal; and
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59	59	WHEREAS, under Hawaii's existing health care insurance system, health insurance companies have used their unilateral control over how health care is organized and paid for to erect obstacles to care for patients through excessive prior authorizations, formulary restrictions, and networks with limited physician participation; and
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63	63	WHEREAS, this system also burdens physicians and hospitals with administrative demands, such as pay for performance, pay for documentation, and capitation, all of which require much more detailed documentation and data reporting while controlling and restricting payment for primary care in particular, which results in physicians being driven out of practice or leaving the State; and
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67	67	WHEREAS, health care rates are skyrocketing, creating an affordability and accessibility crisis for Hawaii's residents; and
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71	71	WHEREAS, the two largest cost drivers of health care in the United States and Hawaii are:
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75	75	(1) High administrative costs due to reliance on a competitive insurance business model that incentivizes denial and obstruction of care, micromanagement of doctors and hospitals, and attempts to avoid covering or paying for sicker and socially disadvantaged patients and populations, resulting in disparities in access to care; and
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79	79	(2) The high cost of prescription drugs; and
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83	83	WHEREAS, for more than a quarter of a century, Hawaii was far ahead of most other states, often calling itself the "Health State" because of the Hawaii Prepaid Health Care Act of 1974, and was once known for having a low percentage of residents without health insurance, which was between two and five percent in 1994; and
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87	87	WHEREAS, as a result of the coronavirus disease 2019 pandemic, thousands of Hawaii residents have lost their jobs and health insurance, making it critical for the State to support struggling families by ensuring preventive care and limiting out-of-pocket costs; and
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91	91	WHEREAS, the safeguarding of access to health care, solidification of the essential health benefits that have changed thousands of lives, and improvement of overall access to care requires the preservation of certain important aspects of the federal Patient Protection and Affordable Care Act and the expansion of access to care for residents of Hawaii; and
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95	95	WHEREAS, negotiations between the health insurance industry and the Obama Administration in 2011 allowed health insurance plans to reclassify "medical management" costs as health care instead of administrative costs for the purposes of reporting medical loss ratios, enabling large administrative costs to be hidden; now, therefore,
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99	99	BE IT RESOLVED by the Senate of the Thirty-first Legislature of the State of Hawaii, Regular Session of 2022, the House of Representatives concurring, that the Legislative Reference Bureau is requested to conduct a financial analysis of the managed care organizations that administer the Employer-Union Health Benefits Trust Fund by auditing the amounts paid for health care and amounts paid for administrative services; and
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103	103	BE IT FURTHER RESOLVED that in its financial analysis, the Legislature Reference Bureau is requested to:
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107	107	(1) Conduct an analysis of the effects of payment reforms and payment of primary care physicians with capitation on practice administrative costs and burdens and their contributions to Hawaii's physician shortage;
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111	111	(2) Analyze "medical management" administrative costs and the administrative cost of payment reforms from payments to providers for provision of health care; and
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115	115	(3) Investigate other issues it deems relevant; and
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119	119	BE IT FURTHER RESOLVED that the Legislative Reference Bureau is requested to submit a report of its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2023; and
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123	123	BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of the Legislative Reference Bureau and Administrator of the Hawaii Employer-Union Health Benefits Trust Fund.
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131	131	OFFERED BY: _____________________________
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135	135	OFFERED BY:
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137	137	_____________________________
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139	139	Report Title:
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141	141	Legislative Reference Bureau; Employer-Union Health Benefits Trust Fund; Financial Analysis