CONFERENCE COMMITTEE REPORT NO. 143

                            Honolulu, Hawaii
                                            , 2000

                            RE:   H.B. No. 2392
                                  H.D. 2
                                  S.D. 1
                                  C.D. 1




Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 2000
State of Hawaii

Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 2000
State of Hawaii

Sir:

     Your Committee on Conference on the disagreeing vote of the
House of Representatives to the amendments proposed by the Senate
in H.B. No. 2392, H.D. 2, S.D. 1, entitled:

    "A BILL FOR AN ACT RELATING TO HEALTH,"

having met, and after full and free discussion, has agreed to
recommend and does recommend to the respective Houses the final
passage of this bill in an amended form.

     The purpose of this measure is to require all individual
accident and sickness health care policies and all group health
care contracts to cover outpatient diabetes self-management
training, education, equipment, and supplies.  

     This measure provides:

     (1) Clarification to the assessment amount paid by health
         insurers annually to the Insurance Commission, to effect
         the intent of the legislature in Act 127, Session Laws
         of Hawaii 1999, that all health insurers pay for the
         costs of regulation;

 
 
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     (2) Clarification of the coverage for diabetes self-
         management training, education, equipment, and supplies
         as to the provision of services; 

     (3) A provision to amend Act 121, Session Laws of Hawaii
         1999, relating to establishment of Hawaii mental health
         insurance task force; and

     (4) A provision to move the Hawaii mental health insurance
         task force from the Department of Health to the
         Insurance Division of the Department of Commerce and
         Consumer Affairs and renames the Hawaii mental health
         task force.

     Your Committee on Conference finds that in 1996, the cost of
care attributable to diabetes in Hawaii was $600 million.  The
total cost of care, including costs that are not directly
attributable to diabetes is about three times greater for those
with diabetes, compared to those without.  Cost of caring for
those with diabetes may approach 25% of the United States
Medicare budget.  The high cost of care has refocused attention
on the potential of reducing costs by preventive measures.
Studies show that it is cost effective to treat diabetes with the
goal of normoglycemia, and that the initial investment in
preventive treatment is partially offset by reducing future
expenditure for end-stage complications.  Treatment is more cost-
effective for those with greater risk of complications, including
those with greater life expectancy, ethnic groups, and those with
worse glycemic control.

     After careful consideration, your Committee on Conference
has amended the bill as follows by:

     (1) Incorporating a provision for insurers, health
         maintenance organizations, and mutual benefit societies
         required to provide coverage for outpatient diabetes
         programs to conduct a study of their diabetes coverages;

     (2) Deleting subsections (a)(3), (b), (c), (d), (e) and (f)
         of new HRS section "431:10A-" to allow insurers the
         ability to develop and manage their own programs to best
         meet the needs of its members; 

     (3) Changing the effective date to July 1, 2001, except for
         sections 6, 7, and 8, which shall take effect upon
         approval;

     (4) Providing that sections 6 and 7 shall be repealed on
         June 30, 2003; and

 
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     (5) Reenacting Hawaii Revised Statutes sections 431:2-216
         and 431M-5;

     As affirmed by the record of votes of the managers of your
Committee on Conference that is attached to this report, your
Committee on Conference is in accord with the intent and purpose
of H.B. No. 2392, H.D. 2, S.D. 1, as amended herein, and
recommends that it pass Final Reading in the form attached hereto
as H.B. No. 2392, H.D. 2, S.D. 1, C.D. 1.

                                   Respectfully submitted on
                                   behalf of the managers:

  ON THE PART OF THE SENATE          ON THE PART OF THE HOUSE
                                   
                                   
                                   
                                   
______________________________     ______________________________
SUZANNE CHUN OAKLAND, Co-Chair     RON MENOR, Co-Chair
                                   
                                   
                                   
                                   
______________________________     ______________________________
BRIAN T. TANIGUCHI, Co-Chair       BERTHA C. KAWAKAMI, Co-Chair




______________________________
BRIAN KANNO, Co-Chair