Bill Text: HI SB2030 | 2010 | Regular Session | Amended
Bill Title: QUEST; Interest Payments; State Penalties; Appropriation
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Engrossed - Dead) 2010-03-03 - (H) Referred to HLT/HUS, CPC, FIN, referral sheet 36 [SB2030 Detail]
Download: Hawaii-2010-SB2030-Amended.html
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THE SENATE |
S.B. NO. |
2030 |
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TWENTY-FIFTH LEGISLATURE, 2010 |
S.D. 2 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO HEALTH.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The State's worsening economy has impacted many state programs including those overseen by the department of human services. Frequently, many entities that contract with the department of human services are not reimbursed in a timely fashion for services provided. This is a problem for many entities doing business with the department of human services, including social service agencies as well as contracted health plans providing services to those enrolled in the State's managed medicaid program, QUEST.
Many health plans in the State contract with the department of human services to participate as QUEST health plans as a community service. Unfortunately, delays in payments make it increasingly difficult to provide these services during dire economic times.
In addition, when health plans do not meet the requirements of Hawaii's clean claims law for the processing and timely payment of claims, interest payments are incurred on these delinquent payments. When the State delays payments to health plans for services already provided, a plan may ultimately end up paying interest on these amounts when the delay in payment is clearly beyond the control of the health plan.
To prevent delays in payment from continuing, the legislature believes that QUEST health plans should be exempt from the interest accrual provisions of the clean claims act only in those instances in which the delays are caused by nonpayment from the federal or state government. In addition, the legislature believes that the State should pay a penalty for late payments to the health care plans, and that additional funding for the QUEST plans should be appropriated from the state hurricane reserve trust fund to continue medicaid coverage for Compact of Free Association migrants.
SECTION 2. Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:
"§346‑ Medicaid payments. (a) The State shall pay a health plan with which it has contracted under the State's medicaid program according to the terms of the contract. If circumstances prevent the State from complying with this section, the State shall pay the health plan interest on any amounts remaining unpaid at a rate equal to fifteen per cent per year, commencing on the day after which payment was due and ending on the date of payment.
(b) This section shall not apply in those cases where a delay in payment is due to:
(1) A bona fide dispute between the State, any of its political subdivisions, or the federal government and the contracting health plan concerning the services or goods contracted for;
(2) A labor dispute;
(3) A power or mechanical failure;
(4) Fire; or
(5) Acts of God."
SECTION 3. Section 431:13-108, Hawaii Revised Statutes, is amended by amending subsection (g) to read as follows:
"(g) Notwithstanding section 478-2 to the contrary, interest shall be allowed at a rate of fifteen per cent a year for money owed by an entity on payment of a claim exceeding the applicable time limitations under this section, as follows:
(1) For an uncontested claim:
(A) Filed in writing, interest from the first calendar day after the thirty-day period in subsection (b); or
(B) Filed electronically, interest from the first calendar day after the fifteen-day period in subsection (b);
(2) For a contested claim filed in writing:
(A) For which notice was provided under subsection (c), interest from the first calendar day thirty days after the date the additional information is received; or
(B) For which notice was not provided within the time specified under subsection (c), interest from the first calendar day after the claim is received; or
(3) For a contested claim filed electronically:
(A) For which notice was provided under subsection (c), interest from the first calendar day fifteen days after the additional information is received; or
(B) For which notice was not provided within the time specified under subsection (c), interest from the first calendar day after the claim is received.
The commissioner may suspend the accrual of interest if the commissioner determines that the entity's failure to pay a claim within the applicable time limitations was the result of a major disaster or of an unanticipated major computer system failure.
The commissioner shall automatically suspend the accrual of interest if the entity's failure to pay a claim within the applicable time limitation is the result of late payment to the entity by the State, any of its political subdivisions, or the federal government for services provided to beneficiaries of the state medicaid program."
SECTION 4. Notwithstanding any provisions of chapter 431P, Hawaii Revised Statutes, to the contrary, there is appropriated out of the hurricane reserve trust fund the sum of $ or so much thereof as may be necessary for fiscal year 2010-2011 to partially address the medicaid shortfall, including but not limited to, reducing the number of months in the delay of payments to plans and the providers of health care services, providing medicaid coverage to Compact of Free Association migrants, and addressing the increase in medicaid enrollment.
In addition to the appropriation authorized in this section, the department of human services is authorized to expend up to $140,000,000 or so much thereof as may be necessary for fiscal year 2010-2011 in matching federal funds for the purposes of this section.
SECTION 5. The sum appropriated shall be expended by the department of human services for the purposes of this Act.
SECTION 6. New statutory material is underscored.
SECTION 7. This Act shall take effect on July 1, 2050.
Report Title:
QUEST; Interest Payments; State Penalties; Appropriation
Description:
Exempts QUEST plans from paying interest under the clean claims act when delays are due to non-payment by government payers to QUEST plans. Requires the State to pay interest on late payments to health care plans related to QUEST. Appropriates funds from the hurricane reserve trust fund to pay for medicaid coverage for Compact of Free Association migrants and authorizes the expenditure of matching federal funds.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
