Report Title:

QUEST Medical Assistance Program; Appropriation

 

Description:

Provides for making cost-based payments to federally qualified health centers and rural health centers for services provided under the QUEST medical assistance program.

 

THE SENATE

S.B. NO.

53

TWENTY-FIRST LEGISLATURE, 2001

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to the quest medical assistance program.

 

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

SECTION 1. The legislature finds that it is in the best interests of the State to ensure access to primary and preventive health care to all its residents. This care not only results in a healthier and more productive population but also reduces publicly supported costs for hospital and emergency room use for preventable conditions.

The legislature further finds that certain individuals covered by the QUEST medical assistance program, are not receiving timely and appropriate medical treatment and require additional clinical and supportive services to improve their health.

The legislature further finds that Hawaii has a system of nonprofit community-based health centers that have expertise in caring for those with cultural and socioeconomic barriers to care. These nonprofit community health centers contribute greatly to the economies and livability of the depressed areas they serve by directly or indirectly adding $85.6 million and almost 1,100 jobs to the local economy annually.

The legislature further finds that these community health centers are essential to the State as the health care safety net for an increasing number of uninsured Hawaii residents.

The legislature further finds that, because the State no longer pays health centers what it costs to provide services to patients covered by QUEST, state and federal subsidies are needed now to pay for community health center QUEST losses in addition to subsidies needed to pay for services for the uninsured.

The legislature further finds that fifty-three and eighty-five hundredths per cent (53.85%) of the dollars spent to increase QUEST payments to community health centers are matched by the federal government.

The purpose of this Act is to maximize the availability of federally matchable funds to ensure the viability and sustainability of the nonprofit community health center system of care for the uninsured, persons covered by QUEST, and others who need special access and supportive services.

SECTION 2. Whenever the department of human services contracts with a health plan for the provision of QUEST services to enrollees, that contract shall provide that in the case of services furnished under contract to the health plan’s enrollees by a federally qualified health center or rural health center, payment to the federally qualified health center or rural health center by the plan shall be comparable to, but no less than, the amount that plan pays to its other providers in the same geographic area for comparable services.

At least quarterly, the department of human services shall pay the federally qualified health centers or rural health centers the difference between the capitation or fee for service payments received by the federally qualified health center or rural health center from the health plans and the reasonable cost incurred by the federally qualified health center or rural health center in providing those services.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $700,000, or so much thereof as may be necessary for fiscal year 2001-2002, and the same sum, or so much thereof as may be necessary for fiscal year 2002-2003, for the purposes of this Act.

SECTION 4. The sums appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 5. This Act shall take effect on July 1, 2001.

INTRODUCED BY:

_____________________________