Hawaii House Bill HR142

Hawaii 2022 Regular Session

• Introduced: 3/11/22
• Refer: 3/14/22

Caption

Requesting The Auditor To Conduct A Financial And Performance Assessment Of The Managed-care Organizations That Administer The State's Medicaid Program.

Impact

The bill recognizes several critical issues affecting Hawaii's Medicaid system, particularly excessive administrative burdens, prior authorization challenges, and the high costs of prescription drugs that lead to disparities in care. By commissioning an audit, the resolution aims to pinpoint areas where managed-care organizations may be falling short in providing necessary services and ensuring adequate physician participation within their networks. The expectation is that this assessment will not only provide a clearer picture of financial allocations but also enhance the overall framework within which Medicaid operates in the state.

Summary

H.R. NO. 142 is a resolution by the House of Representatives of Hawaii aimed at conducting a comprehensive financial and performance assessment of the managed-care organizations responsible for administering the state's Medicaid program. This initiative highlights the ongoing commitment of Hawaii to ensure that all Medicaid beneficiaries have access to high-quality and affordable healthcare, and addresses the growing concerns regarding the performance and accountability of managed care organizations during a time of significant operational challenges in the healthcare sector due to the COVID-19 pandemic.

Contention

Notable points of contention within the bill focus on the inherent complexities of Medicaid managed care and the balance between administrative oversight and care delivery. Concerns were raised regarding inaccurate provider lists and practices such as 'upcoding', which may inflate costs or misrepresent the accessibility of care. Opponents argue that the existing administrative models may inadvertently hinder the quality of care through excessive bureaucracy, which can result in limited access for some populations. Thus, the outcome of the Auditor's assessment could have significant implications for future health policy in Hawaii, influencing how Medicaid services are structured and delivered.