HI SR170

Hawaii Senate Resolution requests health maintenance organizations (HMOs) to comply with the state's Clean Claims Statute (section 431:13-108, Hawaii Revised Statutes) requiring reimbursement of uncontested claims within 30 days of receipt, or 15 days for electronically submitted claims.

Enforcement by the Insurance Division of the Department of Commerce and Consumer Affairs is described as infrequent and primarily complaint-driven rather than based on consistent oversight.

Delayed reimbursements create financial strain on healthcare providers, forcing them to cover payroll and operating expenses while awaiting payment, potentially contributing to medical practice closures.

Rural and underserved communities are disproportionately affected by these delayed payments and resulting healthcare provider instability.

Certified copies of the resolution are to be transmitted to the Governor, Director of Health, Director of Human Services, Director of Commerce and Consumer Affairs, State Health Planning and Development Agency Administrator, and Insurance Commissioner.