STAND. COM. REP. NO. 474

                                   Honolulu, Hawaii
                                                     , 1999

                                   RE:  S.B. No. 837
                                        




Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committee on Health and Human Services, to which was
referred S.B. No. 837 entitled: 

     "A BILL FOR AN ACT RELATING TO MANAGED HEALTH CARE,"

begs leave to report as follows:

     The purpose of this bill is to require mutual benefit
societies, fraternal benefit societies, and health insurance
companies to cover dermatological services with or without a
referral.

     Your Committee received testimony in support of this measure
from the Hawaii Dermatological Society and the Hawaii Federation
of Physicians and Dentists.  Your Committee received
informational testimony from the Insurance Commissioner who
stated that he could support the bill if it can be demonstrated
that direct access to dermatologists will result in lower health
care costs.  Testimony in opposition was received from Kaiser
Permanente.

     Your Committee believes that skin diseases are common in the
general population and should be treated like other ordinary
diseases for health insurance coverage purposes, without
requiring a referral from a primary care physician to a
dermatologist in order to be reimbursed.  In other words,
dermatologists should be considered as primary care physicians
for health insurance purposes. 



 
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                                   STAND. COM. REP. NO. 474
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     Your Committee defers to the Committee on Commerce and
Consumer Protection on whether to amend this measure to include
the correct insurance entities for coverage purposes.

     As affirmed by the record of votes of the members of your
Committee on Health and Human Services that is attached to this
report, your Committee is in accord with the intent and purpose
of S.B. No. 837 and recommends that it pass Second Reading and be
referred to the Committee on Commerce and Consumer Protection.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committee on Health and Human
                                   Services,



                                   ______________________________
                                   SUZANNE CHUN OAKLAND, Chair

 
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