Honolulu, Hawaii
                                                     , 1999

                                   RE:  H.B. No. 1664
                                        H.D. 3
                                        S.D. 1

Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 1999
State of Hawaii


     Your Committee on Ways and Means, to which was referred H.B.
No. 1664, H.D. 3, entitled: 


begs leave to report as follows:

     The purpose of this bill is to strengthen the Hawaii Patient
Bill of Rights and Responsibilities Act by implementing the
recommendations of the patient rights and responsibilities task

     In particular, this bill:

     (1)  Establishes a health insurance revolving fund and
          authorizes appropriations out of the fund to pay for
          medical experts and to fund educational activities;

     (2)  Requires the accreditation of managed care plans;

     (3)  Specifies the type of information that must be included
          in a managed care plan's notice of final determination;

     (4)  Clarifies review hearing rights, procedures, and
          standards in the case of an appeal to the Commissioner
          from a managed care plan's adverse decision;

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     (5)  Strengthens the enrollee information requirements for
          managed care plans; and

     (6)  Establishes detailed requirements for a health plan's
          provision of emergency services.

     Your Committee finds that Act 178, Session Laws of Hawaii
1998, established the Hawaii Patient Bill of Rights and
Responsibilities Act that established certain rights and
protections for enrollees in managed care plans.  Additionally,
Act 178 required the Commissioner to convene a task force
comprised of members from the public and private sectors to
review laws relating to patient rights and responsibilities,
determine whether further action was required to protect patients
under the Act, and report its findings and recommendations to the
1999 regular session of the Legislature.  Your Committee finds
that the recommendations proposed by the task force will further
strengthen patients' rights in the area of health care.

     Upon further consideration, your Committee has amended this
bill by:

     (1)  Deleting the words "to be determined by the
          commissioner" and inserting in their place the words
          "not to exceed an aggregate amount of $150,000" on page
          7, lines 2 to 3, to conform to the dollar cap on the
          one-time deposit to the Commissioner specified in
          section 10 of the bill;

     (2)  Specifying that independent medical evidence is exempt
          from the requirements of section 91-9(g), Hawaii
          Revised Statutes, rather than chapter 91, Hawaii
          Revised Statutes, on page 10, line 20;

     (3)  Adding the phrase ", at the commissioner's discretion,"
          immediately following the word "allowed" on page 12,
          line 1;

     (4)  Specifying that the purpose of the appropriation made
          in section 11 of the bill is to hire medical experts
          for the three-member review panel;

     (5)  Specifying that the purpose of the appropriation made
          in section 12 of the bill is to develop an educational
          awareness program regarding managed health care in
          Hawaii; and

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     (6)  Making technical, nonsubstantive changes for the
          purposes of clarity and consistency.

     As affirmed by the record of votes of the members of your
Committee on Ways and Means that is attached to this report, your
Committee is in accord with the intent and purpose of H.B. No.
1664, H.D. 3, as amended herein, and recommends that it pass
Third Reading in the form attached hereto as H.B. No. 1664, H.D.
3, S.D. 1.

                                 Respectfully submitted on behalf
                                 of the members of the Committee
                                 on Ways and Means,

                                 CAROL FUKUNAGA, Co-Chair

                                 ANDREW LEVIN, Co-Chair

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