STAND. COM. REP. NO. 99

Honolulu, Hawaii

, 2023

RE: H.B. No. 663

H.D. 1

Honorable Scott K. Saiki

Speaker, House of Representatives

Thirty-Second State Legislature

Regular Session of 2023

State of Hawaii

Sir:

Your Committee on Health & Homelessness, to which was referred H.B. No. 663 entitled:

"A BILL FOR AN ACT RELATING TO BREAST CANCER SCREENING,"

begs leave to report as follows:

The purpose of this measure is to improve breast cancer detection rates in the State by:

(1) Increasing the categories of women required to be covered for mammogram screenings;

(2) Requiring that the existing health insurance mandate for coverage of low-dose mammography include digital mammography and digital breast tomosynthesis;

(3) Defining "digital breast tomosynthesis"; and

(4) Requiring health care service providers to be reimbursed at rates accurately reflecting the resource cost specific to each service, including any increased resource cost after January 1, 2023.

Your Committee received testimony in support of this measure from the Hawaii Medical Association, Hawaii Radiological Society, and four individuals. Your Committee received comments on this measure from the Department of Health, Department of Commerce and Consumer Affairs, Hawaii Medical Service Association, and Kaiser Permanente Hawaii.

Your Committee finds that there is ample data showing that annual mammographic screenings significantly reduce breast cancer deaths and morbidity and that effective screening programs are in the best interest of the State and its residents. Your Committee further finds that the guidelines issued by the United States Preventive Task Force with respect to breast cancer screening were a significant departure from screening guidelines issued by leading clinical organizations and, if implemented, would result in insurance plans no longer being required to cover annual mammography without cost sharing for millions of women between forty and forty-nine years of age. This measure is intended to improve public health by increasing access to breast cancer screening, which will in turn play a pivotal role in reducing breast cancer mortality.

Your Committee has amended this measure by:

(1) Changing the required coverage of low-dose screening mammography for occult breast cancer to be in line with national standards in accordance with American College of Radiology guidelines;

(2) Removing the requirement that health care service providers be reimbursed at rates accurately reflecting the resource costs specific to each service, including any increased resource cost, after January 1, 2023;

(3) Changing the effective date to June 30, 3000, to encourage further discussion; and

(4) Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.

As affirmed by the record of votes of the members of your Committee on Health & Homelessness that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 663, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 663, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.

Respectfully submitted on behalf of the members of the Committee on Health & Homelessness,

____________________________

DELLA AU BELATTI, Chair