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SR 170

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 Stanley Chang and 4 co-sponsors

Resolution urges Hawaii HMOs to comply with state Clean Claims statute requiring timely healthcare claim reimbursements and establish accountability measures for late payments.

Referred to HHS/CPN.
#cleanclaims #healthcareclaims #healthmaintenanceorganizations #reimbursement
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Bill Summary · SR 170

Legislative bill overview

SR 170 is a resolution requesting that Hawaii's Health Maintenance Organizations (HMOs) comply with and be held accountable under the state's Clean Claims statute for processing and reimbursing healthcare claims in a timely manner. The bill does not create new law but formally urges HMOs to adhere to existing payment standards and face consequences for non-compliance.

Why is this important

Healthcare providers and patients depend on timely claim reimbursement to maintain cash flow and access to care. Delayed payments burden small medical practices, hospitals, and ultimately increase costs passed to patients. This resolution signals legislative concern about whether HMOs are actually meeting their existing legal obligations.

Potential points of contention

  • Enforcement mechanism unclear: Resolutions are advisory requests without legal force; actual enforcement depends on existing statute authority and regulatory agency action, which may already be inadequate
  • HMO compliance claims: HMOs may argue they already comply with Clean Claims timelines and dispute whether additional accountability measures are necessary or would increase administrative costs
  • Definition of "timely": The statute's specific payment timelines (often 30-45 days) may be disputed as realistic for complex claims, especially those requiring medical review or additional documentation

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

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