HI HCR137

Requests health maintenance organizations (HMOs) in Hawaii to comply with and be held accountable for timely reimbursement of health care claims under the state's Clean Claims Statute (section 431:13-108, Hawaii Revised Statutes).

Current law requires HMOs to reimburse uncontested claims within 30 days of receipt, or within 15 days for electronically submitted claims.

Notes that enforcement by the Insurance Division of the Department of Commerce and Consumer Affairs occurs infrequently and is typically complaint-driven rather than through consistent oversight.

Expresses concern that delayed reimbursements cause financial distress for health care providers, may contribute to medical practice closures, and disproportionately affect rural and underserved communities.

Directs certified copies of the resolution be sent to the Governor, Directors of Health and Human Services, Director of Commerce and Consumer Affairs, State Health Planning and Development Agency Administrator, and Insurance Commissioner.