HR255

WHEREAS, there has been widespread coverage in the local media that many of Hawaii's physicians, particularly specialists, have chosen to leave the State for various reasons; and

WHEREAS, the Legislature is very much aware of this trend and of the assertions that medical malpractice liability and costly medical malpractice insurance premiums are contributing to this trend; and

WHEREAS, the issues of costly medical malpractice insurance premiums and medical tort reform remain topics of serious, extensive, and ongoing discussions within the Legislature; and

WHEREAS, the Legislature is aware that additional significant reasons have been raised for the departure of physicians from the State; and

WHEREAS, for example, the State's geographic isolation as the nation's only island state located in the middle of the Pacific Ocean may act as a relative barrier to easy interstate migration of professionals, including physicians; and

WHEREAS, the high cost of living in the State affects everyone, including physicians earning relatively higher incomes; and

WHEREAS, the issue of an alleged monopolistic underwriting structure for reimbursement for physicians in the State has been raised as a problem; and

WHEREAS, physicians and hospitals claim that the amounts they are reimbursed for services, regardless of physician network or health insurance plan, are below standard and thus provide an incentive to seek work in another state; and

WHEREAS, it is also alleged that physicians and hospitals are often forced to treat indigent, uninsured, or underinsured patients at a loss either because of low reimbursements or no reimbursements at all; and

WHEREAS, it is further alleged that Medicare and Medicaid reimbursements are too low and do not allow physicians and hospitals to either break even or earn a modest return for providing their services; and

WHEREAS, in 2006, the Legislative Reference Bureau published Medicaid and Quest Provider Payment and Reimbursement Rates, which began the examination of adequate reimbursement to providers for state-funded health care under Medicaid and Quest; and

WHEREAS, it is in the interest of the State to attain a thorough understanding of all the issues and concerns that may contribute to the exodus of physicians from Hawaii to better fashion a comprehensive and effective solution; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-fourth Legislature of the State of Hawaii, Regular Session of 2007, that the Speaker of the House of Representatives is requested to convene a temporary task force to examine all relevant issues that may contribute to the exodus of physicians from Hawaii and to recommend measures that may be taken to retain physicians in the State; and

BE IT FURTHER RESOLVED that the Speaker of the House of Representatives is requested to appoint legislators and stakeholders to the temporary task force; and

BE IT FURTHER RESOLVED that the Speaker of the House of Representatives is requested to convene the task force no later than July 1, 2007, and to terminate the task force on January 15, 2008; and

BE IT FURTHER RESOLVED that the Speaker of the House of Representatives is requested to direct the temporary task force to:

(1) Explore ways in which the State can raise the overall physician and hospital reimbursement rates for services;

(2) Raise Medicare and Medicaid reimbursement rates for physician and hospital services, including working with and fashioning legislative initiatives with Hawaii's congressional delegation on the federal level; and

(3) Recommend ways to retain physicians to work in the State, particularly in rural and underserved areas; and

BE IT FURTHER RESOLVED that the Speaker of the House of Representatives is requested to submit the temporary task force's findings and recommendations, including any necessary proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2008; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Speaker of the House of Representatives, the Chairs of the House Committees on Human Services and Housing, and Health, the Director of Human Services, the Insurance Commissioner, and the Director of Health who, in turn, is requested to notify physicians and representatives of the health insurance industry, mutual benefit societies, and health maintenance organizations.

	OFFERED BY:	_____________________________

Report Title:

Physician Exodus; Legislative Task Force; Examine Reasons

HOUSE OF REPRESENTATIVES	H.R. NO.	255
TWENTY-FOURTH LEGISLATURE, 2007
STATE OF HAWAII