STAND. COM. REP. NO. 2589

Honolulu, Hawaii

RE:    S.B. No. 2668

       S.D. 2

Honorable Ronald D. Kouchi

President of the Senate

Twenty-Eighth State Legislature

Regular Session of 2016

State of Hawaii

Sir:

     Your Committee on Ways and Means, to which was referred S.B. No. 2668, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO INSURANCE,"

begs leave to report as follows:

     The purpose and intent of this measure is to limit a patient's out-of-pocket medical costs when services are not covered by the patient's health plan or are provided by a nonparticipating provider.

     Specifically, the measure:

(1)  Requires providers to make certain disclosures to patients about nonemergency services that are not authorized under the patient's health care plan, prior to providing the services;

(2)  Requires nonparticipating providers to make certain cost disclosures to patients about nonemergency services, prior to providing the services;

(3)  Places a cap on the amount that a nonparticipating provider may charge a patient for services performed without the approval of the patient's health care plan;

(4)  Protects a patient from being liable to a participating provider for any sums that the patient's insurer fails to pay; and

(5)  Limits a patient's out-of-pocket costs for emergency services that are performed by a nonparticipating provider to the out-of-pocket costs that would have been incurred if the services were performed by a participating provider.

     Your Committee received written comments in support of this measure from the Hawaii Medical Service Association.

     Your Committee received written comments on this measure from the Healthcare Association of Hawaii and Hawaii Pacific Health.

     Your Committee finds that balance or "surprise" billings are generally minimized when medical services are covered under a patient's health care plan and provided by a participating provider.  This measure will serve to further promote transparency in the healthcare system by minimizing opportunities for balance billings when medical services are not covered under a patient's health plan or are not provided by a participating provider.

     Your Committee has amended this measure by:

     (1)  Clarifying that nonparticipating health care providers, health care facilities, and hospitals must all give prior notice to patients or prospective patients of the amount or estimated amount of a bill for non-emergency health care services; and

     (2)  Making technical, nonsubstantive amendments for clarity, consistency, and style.

     As affirmed by the record of votes of the members of your Committee on Ways and Means that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 2668, S.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as S.B. No. 2668, S.D. 2.

Respectfully submitted on behalf of the members of the Committee on Ways and Means,

________________________________

JILL N. TOKUDA, Chair