Motor Vehicle Insurance

Requires licensure of health care providers delivering services
pursuant to a motor vehicle insurance policy.   Establishes that
a provider overutilizes treatments when the provider prescribes
or treats in excess of that required by the injury.  Establishes
and appropriates funds for a cost containment investigator.

HOUSE OF REPRESENTATIVES                H.B. NO.1638       
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  Chapter 431:10C, Hawaii Revised Statutes, is
 2 amended by adding a new section to be appropriately designated
 3 and to read as follows:
 4      "431:10C-     Health care providers.  (a)  All health care
 5 providers of personal injury protection benefits as defined in
 6 section 431:10C-103.5 and required optional additional insurance
 7 as described in section 431:10C-302 shall be duly licensed under
 8 the laws of the State.
 9      (b)  A health care provider shall be in good standing and in
10 compliance with all licensing or regulatory requirements
11 established by the department of commerce and consumer affairs,
12 any utilization and treatment guidelines of the provider's
13 professional association, and all rules, memoranda, and decisions
14 adopted and issued by the commissioner.
15      (c)  A health care provider shall be deemed to overprescribe
16 or overutilize treatments and procedures when the provider
17 prescribes or treats more than that required by the nature of the
18 injury and the process of recovery.
19      (d)  The commissioner may use all available information,

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                                     H.B. NO.1638       

 1 including data, reports, and records of insurers and the peer
 2 review organization, and any other relevant information in the
 3 investigation of a health care provider's overprescription or
 4 overutilization of treatments and procedures.
 5      (e)  All investigations, examinations, hearings, and appeals
 6 shall be conducted in accordance with article 2 of this chapter.
 7 The commissioner may fine a health care provider who pursuant to
 8 a hearing has been deemed to have overprescribed or overutilized
 9 treatments and procedures.
10      (f)  A health care provider who is deemed to have
11 overprescribed or overutilized treatments and procedures shall be
12 ineligible to receive payments for services rendered pursuant to
13 sections 431:10C-103.5 and 431:10C-302.
14      (g)  The commissioner may adopt rules pursuant to chapter 91
15 to effectuate the purposes of this section."
16      SECTION 2.  There is created one permanent position for a
17 motor vehicle insurance investigator/cost containment specialist
18 to carry out the purposes of this Act and to provide additional
19 enforcement resources for the insurance division.
20      SECTION 3.  There is appropriated out of the motor vehicle
21 insurance revolving fund the sum of $      , or so much thereof
22 as may be necessary, for fiscal biennium 1999-2001 to carry out
23 section 2 of this Act.  The sum appropriated shall be expended by

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                                     H.B. NO.1638       

 1 the department of commerce and consumer affairs. 
 2      SECTION 4.  New statutory material is underscored.
 3      SECTION 5.  This Act shall take effect upon its approval;
 4 provided that section 3 shall take effect on July 1, 1999.
 6                           INTRODUCED BY:  _______________________