Report Title:

Medicare Fee Schedule; Reimbursement to Mutual Benefit Societies

Description:

Beginning 1/1/2008 requires (1) medical services providers of a mutual benefit society to be reimbursed 100% or more of current Medicare Resource Based Relative Value Scale (MRBRVS) for Hawaii determined by U.S. Dept. of Health & Human Services and updated yearly; (2) hospitals & nursing facilities to be reimbursed at 100% or more of the MRBRVS.

THE SENATE	S.B. NO.	1678
TWENTY-FOURTH LEGISLATURE, 2007
STATE OF HAWAII

A BILL FOR AN ACT

relating to medical reimbursement.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

Part I

     SECTION 1.  Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§432-   Reimbursement; medicare fee schedule. Effective January 1, 2008, and for each succeeding calendar year thereafter, each participating medical services provider within the network of a mutual benefit society in the State shall be reimbursed for the provision of medical services to patients, whether a patient is a participant in a medicaid or QUEST program or not, at a rate not less than one hundred per cent of the fees prescribed in the Medicare Resource Based Relative Value Scale applicable to Hawaii as prepared by the United States Department of Health and Human Services that is in effect for the current year and updated for each calendar year thereafter."

Part II

     SECTION 2.  Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§346-   Reimbursement; hospitals and nursing facilities; medicare fee schedule. Effective January 1, 2008, and for each succeeding calendar year thereafter, each hospital or nursing facility licensed by the state department of health shall be reimbursed for the provision of medical services to patients, regardless of whether a patient is a participant in a medicaid or QUEST program, at a rate not less than one hundred per cent of fees prescribed in the Medicare Resource Based Relative Value Scale system applicable to Hawaii that is in effect for 2006, as prepared by the United States Department of Health and Human Services."

     SECTION 3.  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-   Reimbursement; hospitals and nursing facilities; medicare fee schedule. Effective January 1, 2008, and for each succeeding calendar year thereafter, each hospital or nursing facility licensed by the state department of health shall be reimbursed for the provision of medical services to patients, regardless of whether a patient is a participant in a medicaid or QUEST program, at a rate not less than one hundred per cent of fees prescribed in the Medicare Resource Based Relative Value Scale system applicable to Hawaii that is in effect for 2006, as prepared by the United States Department of Health and Human Services."

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

     "§432-   Reimbursement; hospitals and nursing facilities; medicare fee schedule. Effective January 1, 2008, and for each succeeding calendar year thereafter, each hospital or nursing facility licensed by the state department of health shall be reimbursed for the provision of medical services to patients, regardless of whether a patient is a participant in a medicaid or QUEST program, at a rate not less than one hundred per cent of fees prescribed in the Medicare Resource Based Relative Value Scale system applicable to Hawaii that is in effect for 2006, as prepared by the United States Department of Health and Human Services."

     SECTION 5.  There is appropriated out of the general revenues of the State of Hawaii the sum of $        , or so much thereof as may be necessary for fiscal year 2007-2008, and the same sum, or so much thereof as may be necessary for fiscal year 2008-2009, for the purposes of this part.

     The sums appropriated shall be expended by the department of human services for the purposes of this part.

Part III

     SECTION 6.  New statutory material is underscored.

     SECTION 7.  This Act shall take effect upon its approval except that section 5 shall take effect on July 1, 2007.

INTRODUCED BY:

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