HI SCR175

Requests health maintenance organizations (HMOs) in Hawaii to comply with the Clean Claims Statute (section 431:13-108, Hawaii Revised Statutes), which requires reimbursement of uncontested claims within 30 days of receipt, or 15 days for electronically submitted claims.

Expresses concern that enforcement by the Insurance Division of the Department of Commerce and Consumer Affairs occurs infrequently and relies primarily on after-the-fact complaints rather than consistent oversight.

Notes that delayed reimbursements cause financial distress for health care providers, forcing them to cover payroll and operating expenses while waiting for payment, which may contribute to medical practice closures.

Highlights that payment delays disproportionately affect rural and underserved communities and threaten patient access to medical care.

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