STAND. COM. REP. NO. 1216
Honolulu, Hawaii
RE: H.B. No. 1471
H.D. 1
S.D. 1
Honorable Colleen Hanabusa
President of the Senate
Twenty-Fourth State Legislature
Regular Session of 2007
State of Hawaii
Madam:
Your Committees on Health and Human Services and Public Housing, to which was referred H.B. No. 1471, H.D. 1, entitled:
"A BILL FOR AN ACT RELATING TO PUBLIC HEALTH,"
beg leave to report as follows:
The purpose of this measure is to ensure the availability of quality health care services for individuals who are uninsured, underinsured, or Medicaid recipients.
Specifically, this measure:
(1) Establishes procedures within the Department of Human Services for the reconciliation of payments to federally qualified health centers and rural health centers in the State;
(2) Allows for adjustment of prospective payment system rates for any adjustment in scope of services furnished by federally qualified health centers or rural health centers;
(3) Makes eligible for prospective payment system reimbursement certain services, including visits, provided by federally qualified health centers or rural health centers; and
(4) Requires the Department of Health to provide certain resources to nonprofit, community-based healthcare providers for direct medical care for the uninsured, and appropriates funds for this purpose.
Your Committees received testimony in support of this measure from the Hawaii Primary Care Association, the Healthcare Association of Hawaii, Waikiki Health Center, West Hawaii Community Health Center, Inc., Molokai Community Health Center, Hamakua Health Center, Ho‘ola Lahui Hawaii, Kalihi-Palama Health Center, Community Clinic of Maui, Waianae Coast Comprehensive Health Center, Kokua Kalihi Valley, and two individuals. The Department of Health and the Department of Human Services submitted comments on this measure.
Your Committees find that federally qualified health centers are the best system of community-based primary care for people who are uninsured, underinsured, or Medicaid recipients.
Your Committees amended this measure by:
(1) Requiring that the implementation of the new sections added to chapter 346, Hawaii Revised Statutes, by this measure be subject to approval of the state plan by the Centers for Medicare and Medicaid Services;
(2) Clarifying that the reconciliation pertains to managed care supplemental payments;
(3) Changing the Department of Human Services review and rejection time line from ninety days to one hundred twenty days;
(4) Requiring the Department of Human Services to repay the federal share of any overpayment within sixty days of the date of discovery of an overpayment;
(5) Clarifying that an alternative supplemental managed care payment methodology that will make any federally qualified health center or rural health center whole as required under the Benefits Improvement and Protection Act, other than the one set forth in this section, may be implemented as long as the alternative payment methodology is consented to in writing by the federally qualified health center or rural health center to which the methodology applies;
(6) Clarifying in section 346-C(3), Hawaii Revised Statutes, that prospective payment system rates may be adjusted for any projected adjusted rate that is proposed subject to mutual agreement by the Department of Human Services. The federally qualified health center or rural health center shall propose a projected adjusted rate, subject to mutual agreement with the Department of Human Services, within one hundred fifty days of the changes. The proposed projected adjusted rate shall be calculated based on a consolidated basis, where the federally qualified health center or rural health center takes all costs for the facility which would bring in both the costs included in the base rate as well as the changes in additional costs, as long as the federally qualified health center or rural health center has filed its baseline cost report based on total consolidated costs. A net change in the federally qualified health center's or rural health center's rate is calculated by subtracting the federally qualified health center's or rural health center's previously assigned prospective payment system rate from its projected adjusted rate. The Department of Human Services may disallow an unspecified percentage of the net change to account for a combination that includes both increases and decreases during the reporting period;
(7) Requiring a cost report to cover the first full fiscal year, instead of the first two full fiscal years, that includes the change in scope of services;
(8) Deleting the definition "health professional" and instead establishes the parameters of eligibility by defining "visit";
(9) Allowing a federally qualified health center or rural health center that experienced a decrease in the scope of services submit a prospective payment system rate adjustment request to decrease its prospective payment system rate;
(10) Including an appropriation in the amount of $1,061,250 for each year of the 2007-2009 fiscal biennium for the Department of Human Services to implement the new prospective payment system;
(11) Including an appropriation in the amount of $2,000,000 for each year of the 2007-2009 fiscal biennium to the Department of Health for direct medical care to the uninsured;
(12) Changing the effective date from July 1, 2020, to July 1, 2007; and
(13) Making technical, nonsubstantive changes for the purposes of clarity and style.
As affirmed by the records of votes of the members of your Committees on Health and Human Services and Public Housing that are attached to this report, your Committees are in accord with the intent and purpose of H.B. No. 1471, H.D. 1, as amended herein, and recommend that it pass Second Reading in the form attached hereto as H.B. No. 1471, H.D. 1, S.D. 1, and be referred to the Committee on Ways and Means.
Respectfully submitted on behalf of the members of the Committees on Health and Human Services and Public Housing,
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____________________________ SUZANNE CHUN OAKLAND, Chair |
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____________________________ DAVID Y. IGE, Chair |
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