Bill Text: HI HCR199 | 2010 | Regular Session | Amended

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Bill Title: Medicaid benefits; QUEST

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Passed) 2010-04-29 - (H) Resolution adopted in final form. [HCR199 Detail]

Download: Hawaii-2010-HCR199-Amended.html

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STAND. COM. REP. NO. 3238

 

Honolulu, Hawaii

                  

 

RE:    H.C.R. No. 199

       H.D. 1

 

 

 

Honorable Colleen Hanabusa

President of the Senate

Twenty-Fifth State Legislature

Regular Session of 2010

State of Hawaii

 

Madam:

 

     Your Committee on Human Services, to which was referred H.C.R. No. 199, H.D. 1, entitled:

 

"HOUSE CONCURRENT RESOLUTION REQUESTING THE DEPARTMENT OF HUMAN SERVICES TO CONSIDER CERTAIN FACTORS BEFORE ENTERING INTO CONTRACTS WITH MANAGED CARE ORGANIZATIONS THAT PROVIDE MEDICAID BENEFITS UNDER QUEST MANAGED CARE PLANS,"

 

begs leave to report as follows:

 

     The purpose of this measure is to streamline and standardize the process by which the Department of Human Services (DHS) procures services and enters into contracts with service providers regarding future QUEST contracts by requesting that DHS consider certain factors before entering into contracts.

 

     Testimony in support of this measure was submitted by the Hawaii Medical Service Association.  Testimony in opposition to this measure was submitted by DHS and the Hawaii Medical Association.  Written testimony presented to the Committee may be reviewed on the Legislature's website.

 

     Your Committee notes that concerns have been raised regarding the QUEST managed care health program.  Your Committee recognizes that administration of a program of this size and magnitude is challenging.  However, due to the current economic downturn, inefficiencies and waste can escalate and developing ways to streamline large programs and to expend monies more wisely become critical.  Your Committee also finds that the dialogue between health care providers, plans, and the State has been positive and productive.  Your Committee believes that this dialogue should continue in order to benefit all the parties involved, including all citizens of the State of Hawaii.

 

     Your Committee finds that while it is important to take steps towards reforming the QUEST program and procurement processes to encourage efficiency and provide better care to its participants, there are also valid concerns regarding the measure raised by DHS and the Hawaii Medical Association.  DHS points out that, in order to implement co-payments as suggested by the measure, it would have to get approval through a Federal Section 1115 waiver amendment.  This is a way for states to expand Medicare coverage with little or no cost to the government.  States use the Section 1115 waiver to propose to the federal government an expansion of Medicare coverage in their states beyond the traditional categorical eligibility groups or programs.  Because charging QUEST participants co-payments is not currently authorized for the State of Hawaii, a Section 1115 waiver must be submitted and approved by the federal government before a co-payment plan can be implemented.  Your Committee recognizes that this indeed is a hurdle due to time constraints, but believes that the option should be explored and that it is appropriate for DHS to seek the waiver in April of 2011. 

 

     In addition, the Hawaii Medical Association also raised concerns regarding the implementation of cost sharing, stating in its testimony that although a study investigating the effects of cost sharing on patient health, the RAND Health Insurance Experiment, shows that participants' health was unaffected by sharing costs, the poorest and the sickest six per cent of the sample had better outcomes with a free health care program.  Your Committee finds that if QUEST participants' health is adversely affected by having to submit a co-payment, this would be a valid consideration in the ongoing dialogue.

 

     As affirmed by the record of votes of the members of your Committee on Human Services that is attached to this report, your Committee concurs with the intent and purpose of H.C.R. No. 199, H.D. 1, and recommends its adoption.

 

Respectfully submitted on behalf of the members of the Committee on Human Services,

 

		____________________________ SUZANNE CHUN OAKLAND, Chair