Bill Text: HI HCR191 | 2020 | Regular Session | Introduced

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Bill Title: Requesting The Auditor To Conduct A Performance, Financial, And Procurement Audit Of The Department Of Human Services Med-quest Division, Including An Analysis Of Med-quest's Ability To Serve All Individuals Of The State.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced - Dead) 2020-03-11 - Referred to HSH/CPC, FIN, referral sheet 40 [HCR191 Detail]

Download: Hawaii-2020-HCR191-Introduced.html

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HOUSE OF REPRESENTATIVES	H.C.R. NO.	191
THIRTIETH LEGISLATURE, 2020
STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

 

 

requesting the auditor to conduct a performance, financial, and procurement audit of the department of human services med-quest division, including an analysis of Med-QUEST's ability to serve all individuals of the state.

 

 

 

     WHEREAS, Medicaid insurance provides medical coverage for various individuals in need, including individuals with low incomes and disabilities; and

 

     WHEREAS, insurance companies compete for Medicaid contracts because of the higher reimbursement rate received from the federal government; and

 

WHEREAS, currently, five insurance plans offer insurance coverage for Medicaid patients in the State:  Hawaii Medical Service Association; AlohaCare; Kaiser Permanente; Ohana Health Plan; and United HealthCare Insurance; and

 

     WHEREAS, in January 2020, the Department of Human Services announced its contract awards, limiting the Medicaid insurance options available to Medicaid recipients in the State to four providers on Oahu and two providers for the neighbor islands; and

 

     WHEREAS, representatives of Med-QUEST have noted that this downsize in the pool of Medicaid insurers in the State is intended as part of its QUEST Integration plan to simplify choice for patients and billing processes for providers; and

 

     WHEREAS, the Department of Human Services has created an inequitable provision of services by limiting to two the number of QUEST health plans available to Medicaid recipients on the neighbor islands, while allowing recipients based on Oahu four choices; and

 

WHEREAS, this unprecedented move could require more than fifty thousand Medicaid recipients living on neighbor islands, including many thousands on the island of Maui, to change their insurance plans; and

 

     WHEREAS, these contract awards, totaling $17,000,000,000, were scheduled to be disbursed over the next decade, effective July 2020; and

 

     WHEREAS, these contract awards are currently suspended, as AlohaCare, a Hawaii-based insurer that was not selected for an all-island contract, filed a Notice of Protest against the Med-QUEST decision on January 29, 2020; and

 

     WHEREAS, the future of the Department of Human Services' QUEST Integration plan is uncertain and leaves many impacted communities in limbo, especially with respect to continuity of care; now, therefore,

 

     BE IT RESOLVED by the House of Representatives of the Thirtieth Legislature of the State of Hawaii, Regular Session of 2020, the Senate concurring, that the Auditor is requested to conduct a performance, financial, and procurement audit of the Med-QUEST Division of the Department of Human Services, including an analysis of Med-QUEST's ability to serve all individuals of the State; and

 

     BE IT FURTHER RESOLVED that the Med-QUEST Division of the Department of Human Services is requested to submit a report to the Legislature not later than August 1, 2020, explaining its decision to reduce the number of insurance providers for Medicaid recipients, particularly Medicaid recipients on islands other than Oahu, with a detailed summary, including any relevant data, of:

 

     (1)  How, when, and why its decision to reduce the number of Medicaid insurance providers was made; and

 

     (2)  A plan to address any potential issues this reduction in available Medicaid insurance providers will cause, including a plan to aid the many tens of thousands of Medicaid recipients who will have to choose a new health plan; and

 

     BE IT FURTHER RESOLVED that the Auditor is requested to submit a report of the Auditor's findings and recommendation to the Legislature not later than twenty days prior to the convening of the 2021 Regular Session; and

 

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Governor, Auditor, Director of Human Services, Director of Health, Administrator of the Department of Human Services Med-QUEST Division, Chief Executive Officers of Hawaii Medical Service Association, AlohaCare, Kaiser Permanente, Ohana Health Plan, and United HealthCare Insurance.

 

 

 

	OFFERED BY:	_____________________________

Report Title: 

Audit of the Med-QUEST Division of the Department of Human Services