SR6 is a Senate Resolution urging the Administrator of the State Health Planning and Development Agency to convene a working group on health insurance reform focused on prior authorization. The resolution states that prior authorization can delay medically necessary care, create administrative burdens for providers, and disproportionately affect rural and medically underserved patients. It also notes that recent federal CMS changes reduce some burdens for certain patients and physicians, but do not address prior authorization practices used by private insurers in Hawaii.
The proposed working group would include representatives from the insurance industry, licensed health care professionals, consumers or employers, and ex officio state health officials. Its charge is to review federal law, Hawaii law, and other states’ laws and recommend reforms that could reduce delays in care. The resolution specifically asks the group to examine response-time standards, longer validity periods for medication and chronic-care authorizations, specialty-based review of adverse determinations, limits on retroactive denials, public reporting of prior authorization data, continuity of authorization when patients change health plans, and ways to reduce the overall volume of requests through exemptions or gold-carding programs.
Because SR6 is a resolution rather than a bill, it does not itself change statutory law or impose new regulatory requirements. Instead, it directs a study and recommendation process that could lead to future legislation or administrative action. Its practical impact is to place prior authorization reform on the state policy agenda and to gather stakeholder input on possible changes affecting insurers, providers, patients, and state health agencies.
The general sentiment reflected in the resolution and committee votes is supportive of reform and concerned about access to care. The measure passed both the Senate Health and Human Services Committee and the Senate Commerce and Consumer Protection Committee unanimously, each with amendments, suggesting broad agreement on the need to study the issue further. The framing of the resolution emphasizes patient access, provider burden, and transparency, indicating a generally pro-reform posture.
The main points of contention are likely to center on how far reforms should go and how they would affect insurer utilization management. Potentially disputed topics include whether response times should be shortened to 24/48 hours, whether prior authorizations should last a full year or for the duration of treatment, whether only in-state same-specialty clinicians should make adverse determinations, and whether public reporting or gold-carding requirements would increase costs or reduce insurer oversight. The resolution attempts to balance these interests by including insurers, providers, consumers, and state officials in the working group.
SR6 does not amend the Hawaii Revised Statutes or create binding insurance rules; it establishes a policy study process and requests a report with findings and proposed legislation. Its impact is to direct the State Health Planning and Development Agency to assemble stakeholders and evaluate possible reforms affecting prior authorization practices by private insurers and public programs, with the goal of informing future legislative or administrative changes.
The sentiment around SR6 appears broadly favorable and reform-oriented. It passed two Senate committees unanimously, both with amendments, indicating little opposition to the idea of studying prior authorization reform. The resolution’s findings reflect concern that current practices delay care and burden patients and providers, especially in rural and underserved communities, while still acknowledging the role of prior authorization in controlling costs and ensuring medical necessity.
Likely areas of contention involve the scope and enforceability of any future reforms recommended by the working group. Insurers may resist shorter turnaround times, longer authorization validity, mandatory specialty-matched reviewers, public disclosure of utilization data, and limits on retroactive denials, while providers and consumer advocates are likely to support those changes as ways to reduce delays and administrative burden. Another possible point of debate is how to apply reforms across private plans versus CMS-regulated coverage and whether gold-carding or exemption programs would be workable and equitable.