Bill Text: HI SB2887 | 2024 | Regular Session | Introduced
Bill Title: Relating To Insurance.
Spectrum: Partisan Bill (Democrat 5-0)
Status: (Introduced - Dead) 2024-01-24 - Referred to HHS, CPN. [SB2887 Detail]
Download: Hawaii-2024-SB2887-Introduced.html
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THE SENATE |
S.B. NO. |
2887 |
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THIRTY-SECOND LEGISLATURE, 2024 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to insurance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
The legislature finds that "any willing provider" laws that require health maintenance organizations to enter into contracts with qualified providers who are willing to accept a plan's terms and rates can benefit the State's diverse communities, and that at least twenty-nine other states have some type of any willing provider law as of the fall of 2022.
Accordingly, the purpose of this Act is to establish an any willing provider law for the State that prohibits health maintenance organizations from discriminating against certain health care providers that meet the terms and conditions for participation established by the health maintenance organization.
SECTION 2. Chapter 432D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:
"§432D- Any willing provider; enrollment. (a) A health maintenance organization operating in
the State shall offer to each of its enrollees a point-of-service plan option
that allows a covered individual to receive covered services from a licensed
health care provider in the State who is outside the health maintenance
organization's network, without obtaining a referral or prior authorization
from the health maintenance organization; provided that:
(1) The point-of-service plan option may
require that an enrollee pay a higher deductible or copayment and higher
premium for the plan; and
(2) The health care provider chosen by
the enrollee is:
(A) Located in the same county as the
enrollee; and
(B) Willing to meet the terms and
conditions, including schedule of fees, covered expenses, utilization
regulations, and quality standards, established by the health maintenance
organization, to provide services to the enrollee.
(b) A health maintenance organization shall
provide each enrollee with an opportunity at the time of enrollment and during
the annual open enrollment period to enroll in the point-of-service plan
option. The health maintenance
organization shall provide a written notice of the point-of-service plan option
to each enrollee and shall include in that notice a detailed explanation of the
financial costs to be incurred by an enrollee who selects the point-of-service
plan option.
(c) For the purposes of this section, the term "health care provider" has the same meaning as defined in section 432D‑23.5."
SECTION 3. New statutory material is underscored.
SECTION 4. This Act shall take effect upon its approval.
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INTRODUCED BY: |
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Report Title:
Insurance; Health Insurance; Health Care; Discrimination; Insurers; Covered Services; Health Maintenance Organizations
Description:
Prohibits health maintenance organizations from discriminating against certain health care providers that meet the terms and conditions for participation established by the health maintenance organization.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.
