Report Title:

Physician Nutrition Specialist; Insurance Reimbursement

Description:

Requires insurance reimbursements for services provided by physician nutrition specialists to be commensurate with reimbursements for services provided by other board certified physician specialists.

HOUSE OF REPRESENTATIVES

H.B. NO.

412

TWENTY-SECOND LEGISLATURE, 2003

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to insurance.

 

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

SECTION 1. Heart disease, cancer, stroke, and diabetes are among the ten leading causes of death in the United States, according to the Center for Disease Control and Prevention (CDC). In Hawaii, the number of deaths per 100,000 population that occurred in 1999 due to these diseases were 201, 154, 63, and 17, respectively, as reported by the Kaiser Family Foundation (Foundation).

The CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) reports that people who are overweight or obese increase their risk for heart disease, diabetes, some cancers, and high blood pressure, in addition to arthritis-related disabilities. Foundation statistics show that in 2000, Hawaii had an overweight and obesity rate of forty-nine per cent and 47,000 adults were diagnosed with diabetes.

According to the NCCDPHP, although chronic diseases, such as heart disease, cancer, and diabetes, are among the most common and costly health problems, they are also among the most preventable. Adopting healthy behaviors, including eating nutritious foods, can prevent or control the devastating effects of these diseases.

The importance of nutrition in the prevention and control of chronic, life-threatening diseases underscores the importance of medical treatment based on nutritional assessment and intervention, and supports the application of a more equitable fee schedule for physicians who provide these services. An internal medicine practitioner with a specialty in nutrition who diagnoses and treats a patient at risk of or suffering from heart disease should be no less compensated than a physician with a specialty in cardiology rendering diagnosis and treatment services. Yet, under the fee schedules adopted by health insurers, the former receives compensation at a lesser rate than the latter.

Requiring equitable compensation for physicians with a nutrition specialty or subspecialty benefits both the health insurance industry and consumers. Currently, Hawaii has only one physician specialist in nutrition. A more equitable fee schedule will encourage other physicians to develop this specialty and, thereby, increase the availability of medical professionals trained to address the pathology of disease from a nutritional standpoint. In addition, the increased used of preventative and noninvasive procedures to avoid the onset or progression of disease will reduce the need for the use of more invasive, risky, and costly procedures, thereby producing savings in health care costs for insurers and consumers alike.

The purpose of this Act is to require insurers to reimburse physician nutrition specialists at a rate commensurate with other board certified physician specialists.

SECTION 2. Chapter 431:10A, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§431:10A-    Physician nutrition specialist; reimbursement. (a) Reimbursement for services provided by a physician nutrition specialist under a policy of accident and sickness insurance delivered or issued for delivery in this State shall be commensurate with reimbursement for services provided by other board certified physician specialists.

(b) "Physician nutrition specialist" for purposes of this section means a physician who:

(1) Is licensed under chapter 453 or chapter 460;

(2) Is board certified in a specialty; and

(3) Holds a master's degree or higher in nutrition."

SECTION 3. Chapter 432:1, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432:1-    Physician nutrition specialist; reimbursement. (a) Reimbursement for services provided by a physician nutrition specialist under an individual or group hospital or medical service plan, policy, contract, or agreement in this State shall be commensurate with reimbursement for services provided by other board certified physician specialists.

(b) "Physician nutrition specialist" for purposes of this section means a person who:

(1) Is licensed under chapter 453 or chapter 460;

(2) Is board certified in a specialty; and

(3) Holds a master's degree or higher in nutrition."

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect upon its approval.

INTRODUCED BY:

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