STAND. COM. REP. NO. 2347

                                   Honolulu, Hawaii
                                                     , 2000

                                   RE:  S.B. No. 2655
                                        S.D. 1




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

Sir:

     Your Committee on Health and Human Services, to which was
referred S.B. No. 2655 entitled: 

     "A BILL FOR AN ACT RELATING TO HEALTH,"

begs leave to report as follows:

     The purpose of this measure is to strengthen the patient's
bill of rights and responsibilities law.

     Your Committee received testimony in support of this measure
from the State Insurance Commissioner, Hawaii Medical
Association, Legal Aid Society of Hawaii, Kaiser Permanente,
University of Hawaii at Manoa, Hawaii Nurses' Association, Kokua
Council, Hawaii Medical Services Association, and an individual.
Testimony in opposition was received from the Hawaii Biodyne,
Inc., American Academy of Pediatrics, Hawaii Psychological
Association, and an individual.  Informational testimony was
presented by the Department of Health.

     This measure:

     (1)  Establishes an expedited process for appeal of a
          managed care plan's decision;

     (2)  Extends the time period to request an external review
          of a managed care plan's final determination; and

     (3)  Establishes a standard for determining whether a health
          intervention is a medical necessity.

 
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     This measure is a result of the work of the Patients Bill of
Rights Task Force, established by Act 178, Session Laws of Hawaii
1998, to review various laws that may affect patient's rights in
this State.  The twenty members of the task force represent
various organizations and agencies of diverse interests.  This
measure contains the recommended legislation of the task force,
in response to Senate Concurrent Resolution No. 152, 1999,
requesting the task force to develop further legislation and
conduct a study of the term "medical necessity".

     Your Committee believes that this measure is in the best
interest of the patients enrolled in medical insurance plans.
Since the enactment of the patients' bill of rights and
responsibilities law in 1998, your Committee continues its
function of oversight by recommending revisions to respond to new
developments and new problems in patient care.  Your Committee
believes that this measure is balanced so as not to be onerous to
managed care plans and is beneficial to patients in those plans.

     Your Committee has amended this measure by:

     (1)  Replacing references to "physician" with "health care
          provider"; and

     (2)  Clarifying the reference to peer-reviewed literature to
          include National Institute of Mental Health along with
          National Institute of Health, and deleting all other
          organizations.

     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. 2655, as amended herein, and recommends that it pass
Second Reading in the form attached hereto as S.B. No. 2655,
S.D. 1, 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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