S.B. 2530 Summary

• Establishes the Hawaii Healthcare Claims Uniform Reporting and Evaluation System under the Department of Commerce and Consumer Affairs to collect, analyze, and distribute health insurance claims data.

• Requires health insurers with 200+ enrolled members to register annually and submit medical claims, pharmacy claims, and member eligibility files to the insurance commissioner on monthly, quarterly, or annual schedules based on member count.

• Classifies data as unrestricted (public use files available to anyone), restricted (limited use research data requiring approved applications and data use agreements), or unavailable (not releasable).

• Imposes a fee of 2 cents per claim submitted and establishes penalties ranging from $1,000-$10,000 weekly for non-compliance and up to $50,000 for violations involving commercial use or misuse of confidential data.

• Creates a special fund from healthcare claims fees and penalties to operate and improve the uniform reporting and evaluation system.