HOUSE OF REPRESENTATIVES

H.B. NO.

2481

TWENTY-EIGHTH LEGISLATURE, 2016

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

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

 


     SECTION 1.  The state health planning and development agency (SHPDA) is tasked with promoting accessibility to quality health care services for all people of the State at reasonable cost.

     The legislature finds that health care payers collect and analyze health care services claims and payment information for federal regulatory compliance and business accounting purposes.  Reporting health care services claims and payment information to SHPDA would support collection analysis and dissemination of medical treatment claims and payment information, and lend to transparency in the health care sector and support public policy decisionmaking.  The legislature believes that consumers of health care and state decisionmakers who regulate health care and insurance should have access to health care claims payment data and analytics.

     The purpose of this Act is to facilitate greater transparency in the health care sector by broadening the scope of health and health care data and other information, including health care services claims and payment information, submitted to SHPDA.

     SECTION 2.  Section 323D-18, Hawaii Revised Statutes, is amended to read as follows:

     "§323D-18  Information required of providers[.] and payers of health care services claims.  (a)  Providers of health care and all payers of claims for payment for health care services delivered to any person, including providers of public or private health insurance, doing business in the State shall submit [such] data and statistical and other reports of information related to health and health care as the state agency finds necessary to the performance of its functions.  The information deemed necessary includes [but is not limited to]:

     (1)  Information regarding changes in the class of usage of the bed complement of a health care facility under section 323D-54(9);

     (2)  Implementation of services under section 323D-54;

     (3)  Projects that are wholly dedicated to meeting the State's obligations under court orders, including consent decrees, under section 323D-54(10);

     (4)  Replacement of existing equipment with an updated equivalent under section 323D-54(11);

     (5)  Primary care clinics under the expenditure thresholds under section 323D-54(12); [and]

     (6)  Equipment and services related to that equipment, that are primarily intended for research purposes as opposed to usual and customary diagnostic and therapeutic care[.]; and

     (7)  Health care services claims and payment data including all information regarding claims or payments for health care services submitted to or received from any payer or insurer, and information about the nature of the reimbursement and the amounts of any administrative fees, discounts, incentive payments, or performance bonuses.

(b)  The state agency shall submit acquired data to a University of Hawaii data center that shall comply with the conflict of interest provisions of section 2794(d)(2) of the federal Patient Protection and Affordable Care Act that requires a data center established under section 2794(c)(1)(C) of the federal Patient Protection and Affordable Care Act to adopt by-laws ensuring that the center and all members of the center's governing board are independent and free from all conflicts of interest."

     SECTION 3.  Section 323D-18.5, Hawaii Revised Statutes, is repealed.

     ["[§323D-18.5]  Information from providers of health insurance.  The state agency may request providers of health insurance doing business in the State to submit to the state agency available statistical, financial, and other reports of information that the state agency finds necessary to perform its functions."]

     SECTION 4.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 5.  This Act shall take effect upon its approval.

 

INTRODUCED BY:

_____________________________

 

 


 


 

Report Title:

State Health Planning and Development Agency (SHPDA); Health and Health Care Information and Data

 

Description:

Broadens the scope of health and health care data and other information submitted to SHPDA.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.