Requesting Health Maintenance Organizations In The State To Adhere To And Be Held Accountable For Issuing Timely Reimbursements Of Health Care Claims Pursuant To The State's Clean Claims Statute.
Summary
SR170 is a Senate resolution requesting that health maintenance organizations (HMOs) in Hawaii comply with the state’s Clean Claims Statute and be held accountable for timely reimbursement of health care claims. The resolution states that uncontested claims should be paid within 30 days of receipt, or within 15 days for electronically submitted claims, and it emphasizes that prompt payment is important to patient access to care and the financial stability of providers.
The measure is framed as a call for stronger compliance and oversight rather than a change to the underlying statute itself. It points to concerns that enforcement by the Insurance Division of the Department of Commerce and Consumer Affairs is infrequent and often complaint-driven, and it highlights the burden delayed reimbursements place on medical practices, especially in rural and underserved communities. The resolution also notes that delayed payments can contribute to practice closures and broader public health risks.
Impact
SR170 does not amend Hawaii law, but it seeks to reinforce existing requirements under section 431:13-108, Hawaii Revised Statutes, the Clean Claims Statute. Its practical impact is to place legislative pressure on HMOs, regulators, and state health agencies to ensure timely payment of uncontested claims and to improve enforcement of current reimbursement deadlines for health care providers.
Sentiment
The overall sentiment reflected in the resolution is strongly supportive of prompt claim payment and sympathetic to health care providers facing reimbursement delays. The bill’s language suggests concern about financial strain on medical practices, patient access, and community health, and it presents timely reimbursement as a public interest issue. No opposing views or recorded votes are included in the provided context.
Contention
The main point of contention is not whether claims should be paid promptly, but whether HMOs and the Insurance Division are adequately complying with and enforcing the existing Clean Claims Statute. The resolution criticizes infrequent enforcement and complaint-based oversight, implying that stronger accountability is needed. It also raises concern that delayed reimbursements disproportionately harm rural and underserved communities, which may be a focal point for advocates seeking more aggressive regulatory action.
Same As
Requesting Health Maintenance Organizations In The State To Adhere To And Be Held Accountable For Issuing Timely Reimbursements Of Health Care Claims Pursuant To The State's Clean Claims Statute.
Same As
Requesting Health Maintenance Organizations In The State To Adhere To And Be Held Accountable For Issuing Timely Reimbursements Of Health Care Claims Pursuant To The State's Clean Claims Statute.