HI SB1516

Amends Hawaii Revised Statutes Section 480-11(d) to add an antitrust exemption for collaborations among health insurers, third-party administrators, health care providers, managed care plans, and government agencies developing uniform administrative procedures.

Exempts from antitrust laws cooperative efforts to develop uniform procedures for measuring health care quality, prior authorization procedures, and drug list methodologies based on clinical efficacy and research-based guidelines.

Requires that all accident and health insurers, third-party administrators, health care providers (including advanced practice registered nurses, physicians, and hospital administrators), managed care plans operating in Hawaii, and the insurance division of the department of commerce and consumer affairs receive notice and opportunity to participate in the collaboration.

Legislative findings indicate uniform administrative standards will reduce provider administrative burden, lower health care costs, improve quality, and allow providers more time for patient care rather than claims processing.

Takes effect upon approval.