RELATING TO HEALTH CARE.

HB2501

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:

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SECTION
1.
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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.
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These costs are borne unevenly across these
institutions, threatening the long-term sustainability of essential health care
services.

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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:

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(1)
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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
;

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(2)
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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;

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(3)
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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

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

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

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"
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323D-
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Mandatory reporting; medicare and
uninsured patients; audits; rules; budget.
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(a)
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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:

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(1)
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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

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(2)
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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.

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

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

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

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

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(A)
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Cost accounting methodologies;

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(B)
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Patient eligibility determinations;

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(C)
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Reporting formats and timelines;

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(D)
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Verification and audit procedures; and

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(E)
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Redistribution calculations.

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(c)
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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.

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(d)
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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.

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

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SECTION
3.
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New statutory material is
underscored.

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SECTION 4.
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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.