Committee to hear insurance bill

LIHU‘E — The House Health Committee will hear a bill today that could change the standards for external review procedures, possibly favoring the National Association of Insurance Commissioners. 

The bill provides uniform standards for external review procedures, based on the NAIC Uniform Health Carrier External Review Model Act.

The changes, according to the bill’s language, are being made to comply with the requirements of the federal Patient Protection and Affordable Care Act of 2010.

Kaua‘i nurse Dana Nolan said medical reviews made by insurance companies are currently carried in the state of Hawai‘i, and such reviews can be appealed. An attorney, paid for by the insurance companies, can go assist the appellant.

“If this bill is passed, they’re going to move this review to the Mainland, so you can’t get there if you wanted to, unless you’re rich and can drop everything, and they won’t pay for the attorney anymore,” Nolan said.

Nolan said the bill would affect many in the community. She said the new bill would also deny an appeal, something she doesn’t think is legal.

“All that is going to be taken away. People would not have a voice,” Nolan said. “That makes me mad, it makes me so bent out of shape.”

The complex bill has 76 pages.

Wording in the bill says that it will impact the public by making “the insurance statutes governing the external review of adverse determinations by health plans consistent and available to enrollees.”

Regarding the Department of Health and other agencies, the “amendments will reduce confusion and inefficiencies in implementing Hawai‘i law.”

House Speaker Calvin Say introduced HB 1047, by request. The bill will be heard today at 9 a.m.

Kaua‘i’s Rep. Dee Morikawa, D-Koloa-Ni‘ihau, is the vice-chair of the committee, which is made up of 10 representatives. She can be reached at (808) 586-6281.

• Léo Azambuja, staff writer, can be reached at 245-3681 (ext. 252) or lazambuja@kauaipubco.com.