STAND. COM. REP. NO. 739

Honolulu, Hawaii

RE: S.B. No. 1411

S.D. 2

Honorable Ronald D. Kouchi

President of the Senate

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Sir:

Your Committee on Commerce and Consumer Protection, to which was referred S.B. No. 1411, S.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO MEDICAID THIRD PARTY LIABILITY,"

begs leave to report as follows:

The purpose and intent of this measure is to clarify third-party liability provisions for medical assistance program claims for payment as required under the federal Consolidated Appropriations Act of 2022.

Your Committee received testimony in support of this measure from the Department of Human Services.

Your Committee finds that the federal Consolidated Appropriations Act of 2022 amended the Social Security Act to establish new state requirements relating to third-party liability for health care services rendered to Medicaid beneficiaries. The new requirements prohibit responsible third-party payers from refusing payment based on a lack of prior authorization under the third-party payer's rules and require third-party payers to be responsible for reimbursing Medicaid providers based on standards of the Medicaid program. This measure conforms state law to the new federal requirements to increase accountability and transparency in health care.

Your Committee has amended this measure by inserting an effective date of July 1, 2050, to encourage further discussion.

As affirmed by the record of votes of the members of your Committee on Commerce and Consumer Protection that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1411, S.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as S.B. No. 1411, S.D. 2.

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

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JARRETT KEOHOKALOLE, Chair