Requires health insurance plans, mutual benefit societies, and health maintenance organizations to reimburse physicians promptly and to pay up to 100% of applicable medicare rates.

A BILL FOR AN ACT

SECTION 1. The legislature finds that physicians provide health care services for reimbursement and, in this sense, they are no different from any other business that is conducted in the State. Physicians have employees who need to be paid promptly and must pay for rent, expenses, and overhead like any other business. However, physicians are often not reimbursed on a timely basis. In many cases, they are also reimbursed at less than the applicable current medicare rates.

The purpose of this Act is to require health insurers, mutual benefit societies operating as hospital and medical services plans, and health maintenance organizations to reimburse physicians promptly and at rates no less than the current applicable medicare rates.

SECTION 2. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A to be appropriately designated and to read as follows:

"§431:10A-    Prompt reimbursement; medicare rates. Each employer group health policy, contract, plan, or agreement issued under this article by a health insurer shall reimburse a physician promptly and at a rate no less than the applicable current medicare rate."

SECTION 3. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432-    Prompt reimbursement; medicare rates. Each individual and group hospital or medical service plan, policy, contract, or agreement issued under this chapter by a mutual benefit society shall reimburse a physician promptly and at a rate no less than the applicable current medicare rate."

SECTION 4. Chapter 432D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432D-    Prompt reimbursement; medicare rates. Each policy, contract, plan, or agreement issued under this chapter by a health maintenance organization shall reimburse a physician promptly and at a rate no less than the applicable current medicare rate."

SECTION 5. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval.