REPORT TITLE:
Direct Pmt. to Hlth. Facility


DESCRIPTION:
Requires insurers, mutual benefit societies, and health
maintenance organizations to pay rural health care facilities
directly regardless of their participatory status. (SD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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THE SENATE                              S.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO HEALTH CARE FACILITY PAYMENTS.



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

 1      SECTION 1.  Chapter 431, Hawaii Revised Statutes, is amended
 
 2 by adding a new section to article 10A to be appropriately
 
 3 designated and to read as follows:
 
 4      "431:10A-    Direct payment to rural health care
 
 5 facilities.  (a)  An insurer, after receiving a claim for payment
 
 6 of benefits under this article, shall pay the indemnity or
 
 7 reimbursement directly to the rural health care facility that
 
 8 provided the services, regardless of the rural health care
 
 9 facility's participatory status with the insurer's plan.
 
10      (b)  If the insurer makes payment to the covered person, the
 
11 insurer shall remain liable for payment to the rural health care
 
12 facility.  This subsection does not prohibit the insurer from
 
13 recovering any amount mistakenly paid to the covered person.
 
14      (c)  For purposes of this section, "rural health care
 
15 facility" is defined by regulations of the United States
 
16 Department of Health and Human Services."
 
17      SECTION 2.  Chapter 432, Hawaii Revised Statutes, is amended
 
18 by adding a new section to article 1 to be appropriately
 
19 designated and to read as follows:
 

 
Page 2                                                     511
                                     S.B. NO.           S.D. 1
                                                        
                                                        

 
 1      "432:1-    Direct payment to rural health care facilities.
 
 2 (a)  A mutual benefit society, after receiving a claim for
 
 3 payment of benefits under this chapter, shall pay the indemnity
 
 4 or reimbursement directly to the rural health care facility that
 
 5 provided the services, regardless of the rural health care
 
 6 facility's participatory status with the society's health care
 
 7 plan.
 
 8      (b)  If the society makes payment to the covered person, the
 
 9 society shall remain liable for payment to the rural health care
 
10 facility.  This subsection does not prohibit the society from
 
11 recovering any amount mistakenly paid to the covered person.
 
12      (c)  For purposes of this section, "rural health care
 
13 facility" is defined by regulations of the United States
 
14 Department of Health and Human Services."
 
15      SECTION 3.  Chapter 432D, Hawaii Revised Status, is amended
 
16 by adding a new section to be appropriately designated and to
 
17 read as follows:
 
18      "432D-    Direct payment to rural health care facilities.
 
19 (a)  A health maintenance organization, after receiving a claim
 
20 for payment of benefits under this chapter, shall pay the
 
21 indemnity or reimbursement directly to the rural health care
 
22 facility that provided the health care services, regardless of
 
23 the rural health care facility's participatory status with the
 

 
Page 3                                                     511
                                     S.B. NO.           S.D. 1
                                                        
                                                        

 
 1 health maintenance organization's plan.
 
 2      (b)  If the health maintenance organization makes payment to
 
 3 the covered person, the health maintenance organization shall
 
 4 remain liable for payment to the rural health care facility.
 
 5 This subsection does not prohibit the health maintenance
 
 6 organization from recovering any amount mistakenly paid to the
 
 7 covered person.
 
 8      (c)  For purposes of this section, "rural health care
 
 9 facility" is defined by regulations of the United States
 
10 Department of Health and Human Services."
 
11      SECTION 4.  New statutory material is underscored.
 
12      SECTION 5.  This Act shall take effect upon it approval.