WHEREAS, one reason for the delay in moving patients out of hospitals is that most long term care facilities require a source of payment before accepting the transfer, and

WHEREAS, many wait-listed patients are eligible but not enrolled in Medicaid/QUEST; and

WHEREAS, Medicaid/Quest is allowed up to 45 days to determine eligibility but the amount of time required to reach the decision is often extended; and

WHEREAS, hospitals receive no reimbursement from commercial payers for patient wait-listed days and either receives partial retroactive reimbursement from Medicaid, usually at rates substantially below cost, or no reimbursement at all; and

WHEREAS, these unreimbursed costs impose a significant financial burden on acute care hospitals throughout the state; now, therefore

BE IT RESOLVED by the House of Representatives of the Twenty-third Legislature of the State of Hawaii, Regular Session of 2006, that the Departments of Health and Human Services are requested to study the impact of delays in Medicaid/QUEST eligibility on acute care availability and hospital reimbursements for wait-listed patients; and

BE IT FURTHER RESOLVED that the Departments of Health and Human Services are requested to report their findings and recommendations to the Legislature no later than twenty days prior to the convening of the Regular Session of 2007; and

BE IT FURTHER RESOLVED that certified copies of this resolution be transmitted to the Director of Health, the Department of Human Services, the Healthcare Association of Hawaii and the Hawaii Long Term Care Association.

Report Title:

Medicaid eligibility on wait-listed patients