Legislative Recap 2016 - HFMA Hawaii · Legislative Recap 2016 ... –Dengue Crises ... • Relating to Discharge Planning (aka “Care Act”) – (HB 2252) – Act 069

Legislative Recap 2016

HFMA Economic/Legislative Update July 15, 2016

Michael Robinson

Vice President

Government Relations & Community Affairs

How A Bill Becomes Law

Where we are currently

• Sent to Governor

• Gov has 45 days to act – Sign (becomes law)

– Not sign (becomes law)

– Veto (6/27)

• 2016 over 5,700 bills introduced (carryover)

• Only 72 Acts signed into law (as of 6/20/2016)

Bill

Result #1: Bill is Enacted

Result #2: Resolution

One thing can’t be altered in a bill….

2016 Realities

– Dengue Crises

– Relatively Healthy State Fiscal Outlook

– Maui Privatization

– Election Year

2016 Legislative Leadership

• Ronald K. Kouchi (D)

Senate President

(Kaua‘i)

• Joe Souki (D)

House Speaker

(Maui/Wailuku)

Opening Day Priorities

• Speaker Souki: “Keep the momentum going.” – 100% renewable energy goals by 2045

– Marijuana Legalization

– Public Private Partnership for Maui Region

• Affordable Housing & Homelessness – Over 50 bills to address homelessness

– HB 1606 ID cards for homeless

• Taxation for Revenue Sources – SB 2028 County Transient Accommodation tax

– SB 2048 Tax on transient vacation rentals

– SB 2492/HB 2073 elimination for dividends paid from REITS

– SB 2586 1% GET to fund education for public school

• Health care Access – SB 2397/HB2252 Discharge Planning

– HB 1740 Medicare acceptance

• Commercial Lease Purchase Option – HB 1635/2135 Leased Fee Conversion for Commercial Property

2016 Opening Day Remarks • Speaker Souki: “Keep the momentum going.”

– 100% renewable energy goals by 2045

– Marijuana Legalization

– Public Private Partnership for Maui Region

• Affordable Housing & Homelessness – Over 50 bills to address homelessness

– HB 1606 ID cards for homeless (DEAD)

• Taxation for Revenue Sources – HB 1554 County Transient Accommodation tax (DEAD)

– SB 2048 Tax on transient vacation rentals (DEAD)

– SB 2492/HB 2073 elimination for dividends paid from REITS (DEAD)

– SB 2586 1.0% GET to fund education for public school (DEAD)

– SB 2478 0.5% GET to fund LTC defined benefit plan (DEAD)

• Health care Access – SB 2397/HB2252 Discharge Planning (ALIVE)

– HB 1740 MD Medicare acceptance/Licensure (DEAD)*

• Commercial Lease Purchase Option – HB 1635/2135 Leased Fee Conversion for Commercial Property (DEAD)*

2016 House Committee Chairs

Della Au Belatti (D), Chair – Health (Makiki)

Angus McKelvey (D), Chair – Consumer Protection (W. Maui)

Sylvia Luke (D), Chair-Finance (Nuuanu)

Karl Rhoads (D), Chair – Judiciary (Downtown)

2016 Senate Committee Chairs

Suzie Chun-Oakland (D),

Chair – Human Services

(Liliha/Palama)

Jill Tokuda (D), Chair-Ways & Means (Kaneohe/Kailua)

Gilbert Keith-Agaran (D), Chair – Judiciary & Labor

(Waikuku/Kahului)

Rosalyn Baker (D),

Chair – Consumer Protection and Health

(South & West Maui)

2017 Senate Committee Chairs

Suzie Chun-Oakland (D),


(Liliha/Palama)



(Waikuku/Kahului)

Rosalyn Baker (D),


(South & West Maui)

2017 Senate Committee Chairs (?)




(Waikuku/Kahului)

Rosalyn Baker (D),


(South & West Maui)

Political Geography

– 51 House Districts

• Oahu: 35

• Maui: 6

• Kauai: 3

• Hawaii 7

– 25 Senate Districts

• Oahu: 17

• Maui: 3

• Kauai: 1

• Hawaii 4

Political Party Realities

– 51 House Districts

• Democrats: 44

• Republicans: 7

• Need 26 for Majority

– 25 Senate Districts

• Democrats: 24

• Republicans: 1

• Need 13 for Majority

Bills DEAD

2

0

• Mandatory Healthcare Worker Vaccination (SB 2394)

• Preauthorization Requirement Liability (HB 2740)

• Clean Claims Act (SB 2667)

• Balance Billing (SB 2668)

• Gender Equity Pay (HB 1909)

• Customized Patient Medication Packages (HB 1757)

• Employer Access to Social Media Accounts (HB 2209) – Intent to VETO

• Pharmacy Non-Network Retail Access (HB 1672)

• Family Leave Employee Fund/Designated Person (SB 2961)

• Extending Family Leave to Care of Sibling (HB1683)

• Community Pharmacy/Network Adequacy (HB 1672)

• Relating to Access to Treatment for Terminally Ill Patients (SB 2181) – GOV VETO

• Relating to HHSC Separation Benefits (SB 2077) – Intent to Veto

• Relating to Sugar Sweetened Beverages for Children (SB 2385)

Mandatory Health care Worker Vaccination

HB 2394

2

1

• Requires annual influenza vaccinations for health care workers. Establishes exemptions for influenza vaccination requirement under

certain conditions.

• Introduced by: BAKER

• Status: DIED in House FIN


HB 2394

2

2


HB 2394

2

3

Preauthorization Requirement

HB 2740

2

4

• Establishes preauthorization standards for all health insurers in the State.

• Requires decisions on preauthorization requests to be made in

accordance with nationally-accepted evidence-based appropriate-use criteria or guidelines and made available to health care providers within a health insurer's network.

• Establishes that an insurer that fails to meet the standards is

civilly liable for any injury that occurs to a patient due to undue delay in receipt of medical treatment or services.

• Introduced by: CACHOLA

• Status: DIED in CONFERENCE COMMITTEE

Clean Claims

SB 2667

2

5

• Requires health insurers to promptly (30 days) pay clean claims for

services. Repeals the exemption of Medicaid claims from the clean

claims definition.



Balance Billing

SB 2668

2

6

• Establishes a dispute resolution process by which a dispute for a bill for

emergency services or a surprise bill may be resolved.

• Specifies disclosure requirements for health care professionals and

health care facilities, including estimated costs for health care services

and information on participating provider networks.

• Specifies that an insured shall not be liable to a health care provider for

any sums owed by an insurer.



Gender Equity Pay

HB 1909

• Amends the provisions for equal pay and sex

discrimination for substantially similar work.

Clarifies employer defenses. Prohibits employer

actions regarding wage disclosure and applicant

wage histories. Requires that employer

advertisements include minimum rate of pay.

• Introduced By: BELATTI

• Status: Died in Senate

CREATING A HEALTHIER HAWAI ʻ I

Customized Patient Medication Packages

HB 1757

28

• Authorizes a pharmacy to provide a customized

patient medication package to any patient of an

institutional facility or any member of the general

public, subject to certain conditions.


• Status: Died in Senate JDL


Social Media Accounts

HB 1739

• Prohibits employers from requiring, requesting, or

coercing employees or potential employees to

provide access to their personal social media

accounts, subject to certain exemptions.

• Introduced By: LOPRESTI

• Status: Transmitted to Governor/VETO


Non-Network Retail Access

HB 1672

30

• Authorizes a beneficiary of a prescription drug benefit plan to obtain a prescription without penalty from a non-network retail community pharmacy located within ten miles of the beneficiary's residence, if the nearest network retail community pharmacy is located ten or more miles away. Requires reimbursement to non-network retail community pharmacist to include a $15 dispensing fee plus the product cost at the higher rate of reimbursement.


• Status: Died in Conference Committee


Family Leave Insurance Program

SB 2961

• Requires the office of the lieutenant governor to work with

the department of labor and industrial relations to conduct

an actuarial study on the cost of implementing the family

leave insurance program and the effect that it may have on

the existing temporary disability insurance program and

prepare a report to the legislature. Appropriates funds for

the actuarial study and report.

• Introduced By: KEITH-AGARAN

• Status: Died in House FIN


Relating to Wahiawa General Hospital

HCR 118

3

2

• Requesting the Governor and Legislature of the State of

Hawai‘i to provide immediate and emergent financial

assistance to Wahiawa General Hospital.

• Introduced by: OSHIRO

• Status: Died in House FIN

Bills Enacted into Law

3

3

• Relating to MD Licensing – (SB 2675) – Act 038

• Relating to Discharge Planning (aka “Care Act”) – (HB 2252) – Act 069

• Relating to Telehealth (SB 2395) – Act 226

• Respiratory Therapist Licensing – (SB 2341) – Act 014

• Relating to Non-General Funds (SB 2252) – Act 043

• Nursys Nurse Licensing (SB 2862) – Act 018

• Electronic Fingerprint Checks for Nursing (HB 1756) – Act 97

• LTC Inflationary Adjustment (HB 1943) – Act 136

• MD Continuing Education (HB 2233) – Act 115

• Relating to Latex (SB 911) – Act 180

• DME Licensing Program (SB 2076) – Act 137

• Maternal Mortality Review Panels (SB 2317) – Act 203

• Mental Health Treatment for Homeless Individuals (SB 2560) – Act 186

• Behavior Analysts Surcharge Reduction (SB 2670) – Act 123

• Relating to Nursing Criminal Background Checks (HB 1756) – Act 97

• Relating to APRNs Scope of Practice (SB 2672) – Act 183

• Hospital General Hospital Funding (HB 1700)

• All Payer All Claims Database (HB 2482) – Act 139


3

4

Relating to MD Licensing (SB 2675)

• Authorizes the Hawaii Medical Board, Board of

Nursing, and Board of Pharmacy to deny a

license to an applicant or impose disciplinary

action against a licensee who has been

disciplined by another state or a federal agency.

• Prohibits a licensee from practicing until a final

order of discipline is issued if the licensee has

been prohibited from practicing in another state.

• Introduced By: BAKER

• Enacted Act on 4/29/2016 Act 038


3

5

Licensing of Respiratory Therapists SB 2341

• Makes permanent the regulation and licensing of respiratory

therapists.


• Enacted on 4/25/2016 as Act 014


3

6

Relating to Discharge Planning HB 2252

• Hospital required to adopt/maintain written discharge policy enabling opportunity:

– Each patient the opportunity to designate a caregiver to be included in the patient’s EHR

– For patient & caregiver to participate in discharge planning

– For patient & caregiver to receive instruction prior to discharge

– Reasonable attempts to notify caregiver of discharge to residence

• Non interference of policy with discharge planning or health care directives

• Childrens Hospital (i.e. Kapi‘olani Medical Center) exempted

• Introduced By: Belatti

• Enacted Act on 6/17/2016 as Act 069

Care Act – June 17 2016

3

7

Bills Passed

3

8

Relating to Non-General Funds SB 2552

• Repeals and abolishes various non-general funds and

accounts

• Early Intervention Special Fund

• Early Childhood Obesity Special Fund

• Hawai‘i Primary Care Association Dental Special Fund

• Hospital Based Poison Center Special Fund

• Introduced By: TOKUDA


Trauma Fund Projected Balances

3

9

Relating to Telehealth

SB 2395

4

0

• Requires that reimbursement requirements for telehealth services apply to all

health benefits plans including managed Medicaid and fee-for-service.

• Clarifies that reimbursement for services provided through telehealth shall be

equivalent to reimbursement for the same services provided via face-to-face

contact between a health care provider and a patient.

• Specifies medical professional liability insurance policy requirements with regard

to telehealth coverage.

• Requires that telehealth encompasses store and forward technologies, remote

monitoring, live consultation, and mobile health.

• Ensures telehealth is covered when originating in a patient's home and other

non-medical environments. Clarifies requirements for physicians and out-of-state

physicians to establish a physician-patient relationship via telehealth.

• Takes effect on 1/1/2017.


• Status: Enacted July 7, 2016 as Act 226


Hospital Sustainability Program (SB 2330)

• Extends the hospital sustainability program for an additional year.

Amends the purposes for which moneys in the hospital sustainability

program special fund, may be used. Amends the assessment schedule,

scope of application, and rates of the hospital sustainability fee.

Appropriates funds out of the hospital sustainability program special fund

for fiscal year 2016-2017.





Nursing Facility Sustainability Program (SB 2213)

• Continues the nursing facility sustainability program for one

additional year. Appropriates funds out of the nursing facility

sustainability program special fund for fiscal year 2016-

2017.

• Introduced By: CHUN OAKLAND




4

3

• DME Licensing Program (SB2076)

• Establishes a durable medical equipment supplier license

program for suppliers of durable medical equipment,

prosthetics, orthotics, and related supplies through the office

of health care assurance. Allows license fees to be

deposited into the office of health care assurance special

fund.

• Introduced By: CHUN OAKLAND

• Status: Enacted 6/29/16 as Act 137

Wahiawa General Hospital Funding

HB 1700

44

• To adjust and request appropriations for Fiscal

Biennium 2015-17 funding requirements for

operations and capital improvement projects of

Executive Branch agencies and programs.

• Introduced By: SOUKI

• Status: Transmitted to Governor


Bills Passed

4

5

All Payer All Claims Database HB 2482

• Broadens the scope of health and health care data and

other information submitted to the state health planning and

development agency (SHPDA)

• Requires SHPDA to collect all Medicaid and EUTF claim data and

provide to UH SSRI to analyze & collect



Relating to HHSC Separation Benefits (Maui)

SB 2077

4

6

• Authorizes public employees facing position abolishment, reduction-in-force

(RIF), or workforce restructuring to opt to receive either (1) severance benefits or (2) special retirement benefit in lieu of exercising any Reduction In Force (RIF) rights.

• Additionally bill requires the State, through the Department of Budget and Finance (B&F), to pay a monthly contribution into the Employer Union Trust Fund (EUTF) on behalf of the employee impacted and their dependent beneficiaries.

• Legislature passed with no $ appropriation included in budget • Estimated cost to State: $40M-60M for Maui alone • Introduced by: TANIGUCHI

• Status: Gov notice of intent to veto, 6/27/16

Maui Memorial Update

4

7

• SB 2077 (HGEA)

• United PW v. David Ige filed in Federal Court

– Filed in Federal Curt as a Constitutional Issue

– 11th Amendment Contract Clause

– “No State shall...pass any...law impairing the obligation of contracts.”

– UPW request for temporary injunction (2017)

Fed Court Decision – Feb 19, 2016

o Collective Bargaining Agreements (CBA) not employment contracts

o CBA guarantees an employee will be employed for duration of the contract.

Ruling: UPW request for injunction denied.

Maui Memorial Update

4

8

• United PW v. David Ige heard on appeal by Federal 9th Circuit

– Same argument

Appeal heard by 9th Circuit Court of Appeals – May 17, 2016

o Sua sponte (court’s own will) 9th Circuit Court of Appeals

reconsidered UPW request expressing concern for displaced

workers

o Court ordered temporary injunction until September 30, 2016

o State to provide progress report by June 30, 2016

Result: HHSC/Kaiser discussions temporarily halted

Maui Memorial Update…Not done yet

4

9

Appeal heard by 9th Circuit Court of Appeals – June 17, 2016

o Court partial lifted temporary injunction, allowing HHSC/State

to continue discussion

Some unanswered question

What about SB 2077?

If Gov vetoes, how will it effect 9th circuit view of injunction?

If Gov enacts SB 2077, how will it effect future privatization?

How long will parties stay committed given delays?

Legislative Recap 2016

Michael Robinson

Vice President

Government Relations & Community Affairs

535-7124

[email protected]

Harbor Court 27th Floor

mailto:[email protected]

Documents

Legislative Recap 2016 - HFMA Hawaii · Legislative Recap 2016 ... –Dengue Crises ... • Relating to Discharge Planning (aka “Care Act”) – (HB 2252) – Act 069