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HCR 137

REQUESTING HEALTH MAINTENANCE ORGANIZATIONS IN THE STATE TO ADHERE TO AND BE HELD ACCOUNTABLE FOR ISSUING TIMELY REIMBURSEMENTS OF HEALTH CARE CLAIMS PURSUANT TO THE STATE'S CLEAN CLAIMS STATUTE.

2026 Regular Session Introduced by Terez Amato and 6 co-sponsors

Hawaii bill requests HMOs comply with clean claims law and timely reimbursement deadlines to protect healthcare provider cash flow and system integrity.

Received from House (Hse. Com. No. 573).
#cleanclaims #healthcareclaims #healthmaintenanceorganizations #reimbursement
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Bill Summary · HCR 137

Legislative bill overview

HCR 137 is a concurrent resolution requesting that health maintenance organizations (HMOs) operating in Hawaii comply with the state's Clean Claims Act by processing and reimbursing healthcare provider claims within statutory timeframes. The bill calls for HMOs to be held accountable for violations through enforcement of existing state law requirements.

Why is this important

Delayed claim reimbursements create cash flow problems for healthcare providers, which can ultimately affect patient care access and provider solvency. Ensuring timely payments protects small medical practices and independent providers who lack large reserves to absorb payment delays, while also maintaining the integrity of the insurance claims system.

Potential points of contention

  • Definitional clarity: The Clean Claims Act has specific requirements and timelines; the resolution's effectiveness depends on whether current law is sufficiently clear or needs updating with stronger enforcement mechanisms
  • HMO compliance costs: HMOs may argue that expedited claims processing requires system upgrades and increased administrative costs, which could be passed to consumers through higher premiums
  • Enforcement mechanism: As a concurrent resolution (not binding legislation), this request lacks statutory teeth—it's unclear what consequences HMOs face for non-compliance or who enforces accountability

Compiled from official sources — confirm details with the bill’s official record.

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