Bill > HR133

This Resolution requests the Legislative Reference Bureau, an independent research and drafting agency for the Hawaii Legislature, to perform a financial audit of managed care organizations (MCOs) that manage the Employer-Union Health Benefits Trust Fund. The audit will examine how much these MCOs spend on actual healthcare services versus how much they spend on administrative costs, which can include things like processing claims, managing provider networks, and other operational expenses. The resolution also specifically asks the Bureau to analyze how payment reforms and capitation (a fixed payment per patient) affect the administrative costs and burdens on primary care physicians, potentially contributing to Hawaii's physician shortage, and to investigate the administrative costs associated with "medical management" practices. The findings and any proposed legislative solutions are to be reported to the Legislature before the 2023 session begins.