HOUSE OF REPRESENTATIVES
TWENTY-EIGHTH LEGISLATURE, 2016
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO INSURANCE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The state health planning and development agency is tasked with promoting accessibility to quality health care services for all people of the State at reasonable cost.
The legislature finds that health care payers collect and analyze health care services claims and payment information for federal regulatory compliance and business accounting purposes. Reporting health care services claims and payment information to the state health planning and development agency would support collection analysis and dissemination of medical treatment claims and payment information, and lend to transparency in the health care sector and support public policy decision making. The legislature believes that consumers of health care and state decision makers who regulate health care and insurance should have access to health care claims payment data and analytics.
The purpose of this Act is to facilitate greater transparency in the health care sector by broadening the scope of health and health care data and other information, including health care services claims and payment information, submitted to the state health planning and development agency.
SECTION 2. Section 323D-18, Hawaii Revised Statutes, is amended to read as follows:
"§323D-18 Information required of
.] and payers of health care services claims. (a)
Providers of health care and all payers of claims for payment for health
care services delivered to any person, including providers of public or private
health insurance, doing business in the State shall submit [ such],
consistent with all federal and state data use and disclosure, privacy,
security, and confidentiality laws, data and statistical and other reports
of information related to health and health care as the state agency finds
necessary to the performance of its functions. The information deemed
necessary includes [ but is not limited to]:
(1) Information regarding changes in the class of usage of the bed complement of a health care facility under section 323D-54(9);
(2) Implementation of services under section 323D-54;
(3) Projects that are wholly dedicated to meeting the State's obligations under court orders, including consent decrees, under section 323D-54(10);
(4) Replacement of existing equipment with an updated equivalent under section 323D-54(11);
(5) Primary care clinics under the expenditure
thresholds under section 323D-54(12); [
(6) Equipment and services related to that equipment,
that are primarily intended for research purposes as opposed to usual and
customary diagnostic and therapeutic care[
(7) Health care services claims and payment data, including information about the nature of the reimbursement and any fees, discounts, incentives, or performance payments affecting the rate of reimbursement from any insurer.
The state agency shall not disclose any individual patient's personal health information in violation of state or federal law.
(b) The state agency shall submit acquired data to a University of Hawaii data center that shall comply with the conflict of interest provisions of title 42 United States Code section 300gg-94(d)(2) that require a data center established under title 42 United States Code section 300gg-94(c)(1)(C) to adopt by-laws ensuring that the center and all members of the center's governing board are independent and free from all conflicts of interest; provided that the state agency shall initially submit data to the college of social sciences, social sciences research institute, pacific health informatics and data center at the University of Hawaii; provided further that the University of Hawaii data center may opt to no longer provide data services to the state agency upon ninety days written notice to the state agency.
(c) The entity accepting health care services claims and payment data shall enter into a negotiated data sharing agreement with any payer or insurer before data is submitted."
SECTION 3. Section 323D-18.5, Hawaii Revised Statutes, is repealed.
[§323D-18.5] Information from
providers of health insurance. The state agency may request providers
of health insurance doing business in the State to submit to the state agency
available statistical, financial, and other reports of information that the
state agency finds necessary to perform its functions."]
SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 5. This Act shall take effect on July 1, 2050.
State Health Planning and Development Agency; Health and Health Care Information and Data
Broadens the scope of health and health care data and other information submitted to the state health planning and development agency. Effective 7/1/2050. (SD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.