HOUSE OF REPRESENTATIVES	H.C.R. NO.	165
TWENTY-NINTH LEGISLATURE, 2017
STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

requesting the auditor to assess the social and financial effects of requiring health insurers, mutual benefit SOCIETIES, and health maintenance organizations to provide coverage for medically necessary cognitive rehabilitation therapy for survivors of traumatic brain injury.

     WHEREAS, traumatic brain injury is damage to the brain, not of a degenerative or congenital nature, that is caused by an external force; and

     WHEREAS, traumatic brain injury may produce a diminished or altered state of consciousness and may result in an impairment of cognitive abilities or physical functioning; and

     WHEREAS, traumatic brain injury is a leading cause of death and disability among children and young adults; and

     WHEREAS, survivors of traumatic brain injury can lead full lives thanks to lifesaving medical techniques and rehabilitation services; however, survivors face a long rehabilitation process that may not be covered by certain health benefit plans; and

     WHEREAS, section 23-51, Hawaii Revised Statutes, requires that "[b]efore any legislative measure that mandates health insurance coverage for specific health services, specific diseases, or certain providers of health care services as part of individual or group health insurance policies, can be considered, there shall be concurrent resolutions passed requesting the auditor to prepare and submit to the legislature a report that assesses both the social and financial effects of the proposed mandated coverage"; and

     WHEREAS, section 23-51, Hawaii Revised Statutes, further provides that "[t]he concurrent resolutions shall designate a specific legislative bill that:

     (1)  Has been introduced in the legislature; and

     (2)  Includes, at a minimum, information identifying the:

         (A)  Specific health service, disease, or provider that would be covered;

         (B)  Extent of the coverage;

         (C)  Target groups that would be covered;

         (D)  Limits on utilization, if any; and

         (E)  Standards of care"; and

     WHEREAS, section 23-52, Hawaii Revised Statutes, further specifies the minimum information required for assessing the social and financial impact of the proposed health coverage mandate in the Auditor's report; and

     WHEREAS, S.B. No. 225, S.D. 1, has been introduced during the Regular Session of 2017 and mandates health insurers, mutual benefit societies, and health maintenance organizations to provide coverage for medically necessary cognitive rehabilitation therapy for survivors of traumatic brain injury, beginning January 1, 2018; and

     WHEREAS, the Auditor last conducted an impact assessment report on cognitive rehabilitation in 2004, pursuant to S.C.R. No. 37 (2004); and

     WHEREAS, the Auditor's Report No. 04-11 reported an inconclusive finding regarding mandated coverage for cognitive rehabilitation and noted that the Auditor's determination was "hampered by the lack of a standard definition [of cognitive rehabilitation] and more effective evidence on effective treatments.  Experts and current literature support the need for more definitive scientific studies.  The issue should be revisited when those studies become available."; and

     WHEREAS, since the Auditor's Report No. 04-11 was issued, a range of studies on the treatment of traumatic brain injuries have been published; and

     WHEREAS, the incidence of traumatic brain injury continues to increase, particularly among veterans who have returned from serving in combat missions overseas; and

     WHEREAS, the Legislature believes that a follow up analysis to Auditor's Report No. 04-11 is warranted; and

     WHEREAS, the Legislature also believes that mandatory coverage for medically necessary cognitive rehabilitation therapy for survivors of traumatic brain injury, as provided in S.B. No. 225, S.D. 1, Regular Session of 2017, will substantially reduce illness and help survivors of traumatic brain injuries in this State lead full, productive lives; now, therefore,

     BE IT RESOLVED by the House of Representatives of the Twenty-ninth Legislature of the State of Hawaii, Regular Session of 2017, the Senate concurring, that the Auditor is requested to conduct an assessment, pursuant to sections 23-51 and 23-52, Hawaii Revised Statutes, of the social and financial effects of mandating health insurers, mutual benefit societies, and health maintenance organizations to provide coverage for medically necessary cognitive rehabilitation therapy for survivors of traumatic brain injury effective January 1, 2018, as provided in S.B. No. 225, S.D. 1, Regular Session of 2017; and

     BE IT FURTHER RESOLVED that the Auditor is also requested to consider the wide range of studies on the treatment of traumatic brain injuries that have been published since Auditor's Report No. 04-11 was issued; and

     BE IT FURTHER RESOLVED that the Auditor is requested to submit its findings and recommendations to the Legislature, including any necessary implementing legislation, no later than twenty days prior to the convening of the Regular Session of 2018; and

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Auditor and the Insurance Commissioner, who in turn is requested to transmit copies to each insurer in the State that issues health insurance policies, contracts, plans, or agreements.

OFFERED BY:

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Report Title: 

Mandated Coverage; Cognitive Rehabilitation Therapy; Traumatic Brain Injury; Auditor; Impact Assessment Report