SB2096 SD1

Report Title:

Health Insurance Reimbursement Payments

 

Description:

Allows health insurance companies and mutual benefit societies to directly reimburse providers who do not participate in their plans. Requires nonparticipating providers to disclose their nonparticipation. (SD1)

 

THE SENATE	S.B. NO.	2096
TWENTY-FIRST LEGISLATURE, 2002		S.D. 1
STATE OF HAWAII

A BILL FOR AN ACT

 

RELATING TO MEDICAL INSURANCE.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. Chapter 431:10A, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§431:10A-   Reimbursement payments to be made directly to non-participating providers. Each policy of accident and sickness insurance issued or renewed in this State, each employer group health policy, contract, plan, or agreement issued or renewed in this State, all policies providing family coverages as defined in section 431:10A-103, and all policies providing reciprocal beneficiary family coverage as defined in section 431:10A-601, may reimburse a non-participating provider of a covered medical and dental service at the non-participating provider rate by paying the non-participating provider directly rather than reimbursing the patient; provided that the non-participating provider has disclosed to the insured, prior to treatment, that the provider does not participate in the patient's health care plan, that the patient will not be covered by the benefits and protections of the health care plan, and that the out-of-pocket expenses of the patient may be higher as a result."

SECTION 2. Chapter 432:1, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432:1-   Reimbursement payments to be made directly to non-participating providers. All individual and group hospital and medical service plan contracts and medical service corporation contracts under this chapter may reimburse a non-participating provider of a covered medical and dental service at the non-participating provider rate by paying the non-participating provider directly rather than reimbursing the patient; provided that the non-participating provider has disclosed to the insured, prior to treatment, that the provider does not participate in the patient's health care plan, that the patient will not be covered by the benefits and protections of the health care plan, and that the out-of-pocket expenses of the patient may be higher as a result."

SECTION 3. New statutory material is underscored.

SECTION 4. This Act shall take effect on July 1, 2002.