STAND. COM. REP. NO.1120
Honolulu, Hawaii
, 2001
RE: S.B. No. 171
S.D. 2
H.D. 1
Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twenty-First State Legislature
Regular Session of 2001
State of Hawaii
Sir:
Your Committee on Consumer Protection and Commerce, to which was referred S.B. No. 171, S.D. 2, entitled:
"A BILL FOR AN ACT RELATING TO HEALTH INSURANCE REIMBURSEMENT,"
begs leave to report as follows:
The purpose of this bill is to clarify requirements under Act 99, Session Laws of Hawaii (SLH) 1999, (Clean Claims Act), which provides for prompt reimbursement of health care provider insurance claims. This bill:
(1) Defines the term "clean claim";
(2) Requires health insurers to provide a system for immediate verification of insurance enrollee eligibility;
(3) Deletes the requirement that health insurers provide notice of the specific reason for contesting, denying or delaying a claim;
(4) Removes language that conditions interest owed by health insurers on late claim payments, on whether or not notice was timely provided;
(5) Requires health insurers to submit a quarterly report to the Insurance Commissioner of unpaid claims and the reasons these claims were contested; and
(6) Becomes effective on July 29, 2051.
The Hawaii Medical Service Association testified in support of this bill. The Insurance Division of the Department of Commerce and Consumer Affairs, Hawaii Chapter American Physical Therapy Association, and Hawaii Medical Association supported the measure and proposed amendments.
The Clean Claims Act was intended to ensure prompt reimbursement of claims made under a health insurance policy by establishing minimum reimbursement requirements and contested claim procedures. However, your Committee finds that there continues to be a problem with health care providers not receiving prompt payment, and insurers withholding payment pending receipt of further information without specifying the information required.
Your Committee finds that the deletion of the notice requirement would provide health care insurers with a means of delaying payments, and has reinstated the notice provisions of the Clean Claims Act.
Your Committee has further amended this bill by:
(1) Including language that allows insurers to eliminate separately mailed notices and instead, include notice with the weekly reimbursement reports currently sent to providers;
(2) Making the Clean Claim Act permanent by repealing the July 1, 2002, sunset date of the Act; and
(3) Changing the effective date of the bill from July 29, 2051, to upon approval.
As affirmed by the record of votes of the members of your Committee on Consumer Protection and Commerce that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 171, S.D. 2, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 171, S.D. 2, H.D. 1, and be placed on the calendar for Third Reading.
Respectfully submitted on behalf of the members of the Committee on Consumer Protection and Commerce,
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____________________________ KENNETH T. HIRAKI, Chair |