Report Title:

Aeromedical Medical Reimbursement Rate

WHEREAS, the State of Hawaii is an island state which consists of a resident population of 1,200,000 people geographically separated throughout eight major islands; and

WHEREAS, approximately 321,000 residents live and work on the rural islands of Maui, Molokai, Lanai, Kauai, Niihau, Kahoolawe, and Hawaii, which hosted about 4,700,000 visitor arrivals in 2000; and

WHEREAS, the only tertiary-level care hospitals are located on the urban island of Oahu; and

WHEREAS, the State has only one air ambulance service that provides the only means of emergency medical transport connecting the neighbor islands to the tertiary medical facilities on the island of Oahu; and

WHEREAS, approximately thirty per cent of the State's inter-island aeromedical flights are Medicare flights; and

WHEREAS, Hawaii's aeromedical services are reimbursed by Medicare Part B insurance at rates that are below cost due to a unique formula where Hawaii's rates are reimbursed at a fixed, rate set according to airports to which flights are directed, compared to nearly all other air ambulance providers nationally that are reimbursed on the basis of a base-rate and mileage; and

WHEREAS, the Health Care Financing Administration's proposed Medicare fee schedule published in the Federal Register on September 12, 2000, demonstrates that Hawaii's current reimbursement rates are more than one-third less than what the Medicare rates should be; and

WHEREAS, Hawaii's Medicare reimbursement rates for air ambulance services have not been adjusted for fourteen years by the United States Congress or by the Health Care Financing Administration, despite increasing flight and medical costs; and

WHEREAS, despite the 1997 Balanced Budget Act requiring the Health Care Financing Administration to implement a new national Medicare schedule by January 1, 2000, that would provide relief over a three-year period to air ambulance providers nationally, promulgation of the final rules have been delayed, with no implementation date set; and

WHEREAS, Hawaii's only fixed-wing aeromedical provider is experiencing a substantial financial hardship due to inadequate Medicare reimbursement, which could result in the demise of the only inter-island medical transport service available to millions of residents and visitors in the State of Hawaii; now, therefore,

BE IT RESOLVED by the Senate of the Twenty-First Legislature of the State of Hawaii, Regular Session of 2001, that the United States Congress is urged to adjust Hawaii's aeromedical reimbursement rates by providing specific relief to Hawaii by providing immediate phase-in of the proposed fee schedule published in the Federal Register on September 12, 2000; and

BE IT FURTHER RESOLVED that the Health Care Financing Administration is urged to allow an immediate phase-in of the proposed Medicare fee schedule for Hawaii; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Majority Leader of the United States Senate, the Chairperson of the United States Senate Finance Committee, the Speaker of the United States House of Representatives, the Chairperson of the United States House Committee on Ways and Means, the members of Hawaii's congressional delegation, the United States Secretary of Health

and Human Services, the Administrator of the United States Health Care Financing Administration, and the Directors of Human Services and Health.