REPORT TITLE:
HMOs


DESCRIPTION:
Requires a quarterly filing for HMOs and provides for a penalty
for failure to comply.  (HB1068 HD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        1068
HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO HEALTH MAINTENANCE ORGANIZATIONS.



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

 1      SECTION 1.  Section 432D-5, Hawaii Revised Statutes, is
 
 2 amended by amending section 432D-5 subsection (a) read as
 
 3 follows:
 
 4      "[[]432D-5[]] Annual [report.] and quarterly reports. (a)
 
 5 Every health maintenance organization shall annually, on or
 
 6 before March 1, file a report verified by at least two principal
 
 7 officers with the commissioner covering the preceding calendar
 
 8 year.  Each health maintenance organization shall file quarterly,
 
 9 on or before the forty-fifth day after each quarter, a copy of
 
10 its quarterly report verified by at least two principal officers
 
11 with the commissioner.  [Such report] These reports shall comply
 
12 with sections 431:3-301 and 431:3-302.  The commissioner may
 
13 prescribe on which forms the reports are to be filed.  In
 
14 addition, the health maintenance organization annually shall file
 
15 with the commissioner the following by the dates specified:
 
16      (1)  An audit by a designated independent certified public
 
17           accountant or accounting firm of the financial
 
18           statements reporting the financial condition and
 
19           results of operations of the health maintenance
 
20           organization on or before June 1, or such later date as
 
21           the commissioner upon request or for cause may specify.
 
Page 2                                                     1068
                                     H.B. NO.           H.D. 1
                                                        
                                                        

 
 1           The health maintenance organization, on an annual basis
 
 2           and prior to the commencement of the audit, shall
 
 3           notify the commissioner in writing of the name and
 
 4           address of the person or firm retained to conduct the
 
 5           annual audit.  The commissioner may disapprove the
 
 6           health maintenance organization's designation within
 
 7           fifteen days of receipt of the health maintenance
 
 8           organization's notice, and the health maintenance
 
 9           organization shall be required to designate another
 
10           independent certified public accountant or accounting
 
11           firm[.];
 
12      (2)  A list of the providers who have executed a contract
 
13           that complies with section 432D-8(d) on or before March
 
14           1; and
 
15      (3)  A description of the grievance procedures, the total
 
16           number of grievances handled through those procedures,
 
17           a compilation of the causes underlying those
 
18           grievances, and a summary of the final disposition of
 
19           those grievances on or before March 1."
 
20      SECTION 2.  Section 432D-17, Hawaii Revised Statutes, is
 
21 amended to read as follows:
 
22      "[[]432D-17[]]  Fees.(a)  The commissioner shall collect
 
23 in advance the following fees:
 

 
Page 3                                                     1068
                                     H.B. NO.           H.D. 1
                                                        
                                                        

 
 1      (1)  For filing an application for a certificate of
 
 2           authority or amendment thereto, $600; and
 
 3      (2)  For all services subsequent to the issuance of a
 
 4           certificate of authority (including extension of the
 
 5           certificate of authority), $400.
 
 6      (b)  The commissioner shall notify the holder of the
 
 7 certificate of authority by written notice at least thirty days
 
 8 prior to the extension date of the certificate.  If the fee is
 
 9 not paid before or on the extension date, a penalty shall be
 
10 imposed in the amount of fifty per cent of the fee.  If the fee
 
11 and the penalty are not paid within thirty days immediately
 
12 following the extension date, the commissioner may revoke the
 
13 certificate of authority and shall not reinstate the certificate
 
14 of authority until the fee and penalty have been paid.
 
15      [(b)] (c)  All fees and penalties collected pursuant to this
 
16 section and penalties collected pursuant to section 432D-14 shall
 
17 be remitted by the commissioner to the director of finance and
 
18 shall be placed to the credit of the general fund."
 
19      SECTION 3.  Statutory material to be repealed is bracketed.
 
20 New statutory material is underscored.
 
21      SECTION 4.  This Act shall take effect upon its approval.