STAND. COM. REP. NO. 671

Honolulu, Hawaii

, 2025

RE: H.B. No. 250

H.D. 2

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Madame:

Your Committee on Consumer Protection & Commerce, to which was referred H.B. No. 250, H.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO HEALTH,"

begs leave to report as follows:

The purpose of this measure is to:

(1) Examine prior authorization practices in the State by requiring utilization review entities to report certain data to the State Health Planning and Development Agency;

(2) Establish timelines for the approval of prior authorization requests to reduce delays for urgent and non-urgent health care services; and

(3) Establish the Health Care Appropriateness and Necessity Working Group to make recommendations to improve and expedite the prior authorization process.

Your Committee received testimony in support of this measure from the Department of Health; State Health Planning and Development Agency; Hawaiʻi Association of Professional Nurses; Hawaii Academy of Family Physicians; ʻAhahui o nā Kauka; Hawaii Medical Association; Mohala Health LLC; American College of Obstetricians and Gynecologists, Hawaii Section; East Hawaii Independent Physicians Association; and three individuals. Your Committee received testimony in opposition to this measure from the Hawaii Medical Service Association. Your Committee received comments on this measure from the Hawaii Association of Health Plans.

Your Committee finds that prior authorization is a health plan cost control process that requires physicians, other health care professionals, and hospitals to obtain advance approval from a health plan before a specific service to a patient to qualify for payment or coverage. Your Committee further finds that prior authorization imposes unnecessary delays in treatment. For example, in one survey, eighty-three percent of requests are subsequently overturned by the health plan. This measure streamlines and increases transparency of the prior authorization process.

Your Committee has amended this measure by:

(1) Extending the deadline, from twenty-four hours to fourteen days, by which a health care facility or health care professional is required to submit requested information before the facility or professional would be required to submit a new prior authorization request to a utilization review entity;

(2) Amending the composition of the Health Care Appropriateness and Necessity Working Group; and

(3) Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.

As affirmed by the record of votes of the members of your Committee on Consumer Protection & Commerce that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 250, H.D. 1, as amended herein, and recommends that it be referred to your Committee on Finance in the form attached hereto as H.B. No. 250, H.D. 2.

Respectfully submitted on behalf of the members of the Committee on Consumer Protection & Commerce,

____________________________

SCOT Z. MATAYOSHI, Chair