HOUSE OF REPRESENTATIVES

H.B. NO.

2501

THIRTY-THIRD LEGISLATURE, 2026

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to health care.

 

 

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

 

     SECTION 1.  The legislature finds that health care institutions in the State expend significant financial resources providing care to medicare beneficiaries with extraordinary medical needs and to uninsured patients who lack the ability to pay.  These costs are borne unevenly across these institutions, threatening the long-term sustainability of essential health care services.

     The purpose of this Act is to balance the financial burden of high-cost medicare and uninsured patients among health care institutions that receive state funding by requiring:

     (1)  Hospitals and hospital systems to submit annual certified reports regarding costs associated with medicare and uninsured patients to the department of health, Hawaii health systems corporation, and state health planning and development agency;

     (2)  The department of health, Hawaii health systems corporation, and state health planning and development agency to review the reports, establish standards and procedures, and adopt rules;

     (3)  The department of health to consider the reports when determining the department's budget request and designate financial assistance requests in an equitable way; and

     (4)  The office of the auditor to conduct periodic audits of the financial assistance distributed to hospitals and hospital systems.

     SECTION 2.  Chapter 323D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§323D-     Mandatory reporting; medicare and uninsured patients; audits; rules; budget.  (a)  Every hospital or hospital system that receives any state general fund appropriation, capital improvement funds, or other state financial assistance shall submit an annual report certified by the auditor to the department of health, Hawaii health systems corporation, and state health planning and development agency that provides the following information:

     (1)  The number of medicare patients whose annual cost of care exceeded $50,000 and the total amount expended by the hospital or hospital system to provide care to these patients; and

     (2)  The number of uninsured patients whose annual cost of care exceeded $5,000 and the total amount expended by the hospital or hospital system to provide care to these patients.

     (b)  The department of health, in coordination with the Hawaii health systems corporation and the state health planning and development agency, shall:

     (1)  Review and verify the reports submitted pursuant to subsection (a);

     (2)  Establish uniform accounting standards and reporting procedures; and

     (3)  Adopt rules pursuant to chapter 91 necessary to carry out the purposes of this section, including rules related to:

          (A)  Cost accounting methodologies;

          (B)  Patient eligibility determinations;

          (C)  Reporting formats and timelines;

          (D)  Verification and audit procedures; and

          (E)  Redistribution calculations.

     (c)  In determining the amount of general fund appropriations, capital improvement funding, or other state financial assistance to be requested in the department of health's budget, the department of health shall consider the reports filed pursuant to subsection (a) and designate financial assistance requests, not to exceed $          , in such a way as to equitably distribute the financial burden associated with medicare and uninsured patients across all state hospitals and hospital systems.

     (d)  The office of the auditor shall conduct periodic audits of the funds distributed to hospitals and hospital systems pursuant to subsection (c) to ensure compliance with this section.

     (e)  For the purposes of this section, "hospital" means an institution licensed by the department of health pursuant to section 321-14.5."

     SECTION 3.  New statutory material is underscored.

     SECTION 4.  This Act shall take effect upon its approval.

 

INTRODUCED BY:

_____________________________

 

 

 

 

Report Title:

DOH; HHSC; SHPDA; Auditor; Hospitals; Hospital Systems; Medicare Patients; Uninsured Patients; Reports; Rules; Financial Assistance

 

Description:

Requires hospitals and hospital systems to submit annual certified reports regarding costs associated with Medicare and uninsured patients to the Department of Health, Hawaii Health Systems Corporation, and State Health Planning and Development Agency.  Requires the Department of Health, Hawaii Health Systems Corporation, and State Health Planning and Development Agency to review the reports, establish standards and procedures, and adopt rules.  Requires the Department of Health to consider the reports when determining the department's budget request and designate financial assistance requests in an equitable way.  Requires the Office of the Auditor to conduct periodic audits of the financial assistance distributed to hospitals and hospital systems.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.