STAND. COM. REP. NO. 3025

                                   Honolulu, Hawaii
                                                     , 2000

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




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

Sir:

     Your Committees on Health and Human Services and Commerce
and Consumer Protection, to which was referred H.B. No. 2392,
H.D. 2, entitled: 

     "A BILL FOR AN ACT RELATING TO HEALTH,"

beg leave to report as follows:

     The purpose of this measure is to require all health
insurance policies to provide coverage for outpatient diabetes
self-management training, education, equipment, and supplies.

     Your Committees received testimony in response to the
proposed Senate Draft as follows:

     (1)  Diabetes:  Department of Health, Hawaii Nurses'
          Association, Hawaii Association of Diabetes Educators,
          Diabetes Advocacy Alliance of Hawaii, Queen's Health
          Management, Papa Ola Lokahi, and six private
          individuals; and

     (2)  Mental health:  State Insurance Commissioner, Mental
          Health Association in Hawaii, National Association of
          Social Workers, Kaiser Permanente, Hawaii Medical
          Service Association, Hawaii Medical Association,
          Queen's Health Management, and Equal Insurance
          Coalition.


 
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     Your Committees find that diabetes is one of the most
prevalent diseases in Hawaii.  Much of the treatment for diabetes
involves self-management, however health insurance policies do
not usually provide coverage for education instruction, including
visits to physicians for consultation on managing the condition.

     Your Committees further find that effective outpatient self-
management by diabetics results directly in a significant
reduction in both the economic and human devastation wrought by
the disease.  There is ample evidence that tight control of blood
sugar levels through patient self-management can dramatically
lower the incidence of complications, increase life expectancy,
and significantly enhance the quality of life of diabetics.  In
addition, studies show that providing diabetics with the
appropriate supplies and training for self-management results in
a decrease in health care services utilization and costs.

     Your Committees have amended this measure by:

     (1)  Adding a clarification to the assessment amount paid by
          health insurers annually to the Insurance Commissioner,
          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;

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

     (3)  Deleting an exception to the prohibition against
          discriminatory rates in mental health insurance
          benefits for health insurance policies covering
          employers with twenty-five or fewer employees and
          government employee health benefit plans;

     (4)  Inserting a provision to amend Act 121, Session Laws of
          Hawaii 1999, relating to establishment of the Hawaii
          mental health insurance task force; and

     (5)  Changing the effective date to:

          (A)  Upon approval for the mental health task force;
               and

          (B)  For the diabetes coverage, July 1, 2001, or the
               earliest date after July 1, 2001, at which group
               policies are renewed, whichever is later. 


 
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     Your Committees note that with regard to the assessment, it
was not the legislature's intent to provide an exemption to any
health plan, and the bifurcated assessment is intended to provide
the smaller plans with time to budget moneys for future
assessments.

     As affirmed by the records of votes of the members of your
Committees on Health and Human Services and Commerce and Consumer
Protection that are attached to this report, your Committees are
in accord with the intent and purpose of H.B. No. 2392, H.D. 2,
as amended herein, and recommend that it pass Second Reading in
the form attached hereto as H.B. No. 2392, H.D. 2, S.D. 1, and be
referred to the Committee on Ways and Means.

                                   Respectfully submitted on
                                   behalf of the members of the
                                   Committees on Health and Human
                                   Services and Commerce and
                                   Consumer Protection,



____________________________       ______________________________
BRIAN KANNO, Co-Chair              SUZANNE CHUN OAKLAND, Chair



____________________________
BRIAN T. TANIGUCHI, Co-Chair

 
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