Honorable Robert Bunda

President of the Senate

Twenty-Second State Legislature

Regular Session of 2003

State of Hawaii

Sir:

Your Committee on Commerce, Consumer Protection and Housing, to which was referred S.B. No. 683, S.D. 1, entitled:

begs leave to report as follows:

The purpose of this measure is to establish provider standards for medically necessary diabetes education.

Testimony in support of this measure was provided by an individual. The Hawaii Medical Service Association (HMSA), Kaiser Permanente, Hawaii Pharmacists Association, and American Healthways testified against the measure.

Your Committee finds diabetes, perhaps more than any other disease, is subject to control through self-management. Diabetes self-management education provides a person with diabetes with the necessary knowledge and skills to assess the person's condition with respect to diet, activity level, and medication, and to respond appropriately to maintain good glucose control.

This measure requires that diabetes education provided under health insurance coverage be provided by a program recognized by either the American Diabetes Association or the National Committee for Quality Assurance, or by a certified diabetes educator. This requirement ensures that diabetes education meets national standards, which in turn, ensures that self-management education is based on a combination of the best scientific evidence and the best practices.

Health maintenance organizations (HMOs) are currently required to provide medically necessary diabetes education for their enrollees pursuant to section 432D-23, Hawaii Revised Statutes (HRS). This provision incorporates by reference the diabetes education requirement of section 431:10A-121, HRS, and makes it applicable to HMOs. The aforesaid notwithstanding and based on the recommendation of HMSA, your Committee has amended this measure by adding a provision to the Health Maintenance Organization Act to directly require HMOs to provide medically necessary diabetes education.

As affirmed by the record of votes of the members of your Committee on Commerce, Consumer Protection and Housing that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 683, S.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as S.B. No. 683, S.D. 2.