§103F-107 Medicaid contracts; nonprofits and for-profits; reporting requirements. (a) All nonprofit or for-profit medicaid healthcare insurance contractors, within one hundred and eighty days following the close of each fiscal year, shall submit an annual report to the department of human services, the insurance division of the department of commerce and consumer affairs, and the legislature. The report shall be attested to by a plan executive located within the State and shall be made accessible to the public.
The report shall be based on contracts administered in the State and shall include:
(1) An accounting of expenditures of MedQuest contract payments for the contracted services, including the percentage of payments:
(A) For medical services;
(B) For administrative costs;
(C) Held in reserve; and
(D) Paid to shareholders;
(2) Employment information including:
(A) Total number of full-time employees hired for the contracted services;
(B) Total number of employees located in the State and the category of work performed; and
(C) The compensation provided to each of the five highest paid Hawaii employees and to each of the five highest paid employees nationwide, and a description of each position;
(3) Descriptions of any ongoing state or federal sanction proceedings, prohibitions, restrictions, ongoing civil or criminal investigations, and descriptions of past sanctions or resolved civil or criminal cases, within the past five years and related to the provision of medicare or medicaid services by the contracting entity, to the extent allowed by law;
(4) Descriptions of contributions to the community, including the percentage of revenue devoted to Hawaii community development projects and health enhancements; provided that contracted services shall not be included in the percentage calculation; and
(5) A list of any management and administrative service contracts for MedQuest services made in Hawaii and outside of the State, including a description of the purpose and cost of those contracts.
(b) The department of human services shall include in all medicaid healthcare insurance plan contracts, the annual reporting requirements of subsection (a).
(c) Any contract under this section shall be governed by the laws of the State of Hawaii.
(d) Within ninety days of receipt of the reports required by this section, the department of human services shall provide a written analysis and comparative report to the legislature. [L Sp 2009, c 12, §2]
Structure Hawaii Revised Statutes
Title 9. Public Property, Purchasing and Contracting
103F. Purchases of Health and Human Services
103F-101 Application of this chapter.
103F-103 Education and training.
103F-104 Exemption from chapter 103D.
103F-105 Preventing impairment of federal funds.
103F-106 Authority of the procurement policy board.
103F-107 Medicaid contracts; nonprofits and for-profits; reporting requirements.
103F-201 Interagency committee on purchase of health and human services.
103F-203 Participation of providers.
103F-301 Powers and duties of the administrator.
103F-302 Delegation of authority of the administrator of the state procurement office.
103F-401 Methods of selection.
103F-402 Competitive purchase of services.
103F-403 Restrictive purchase of services.
103F-404 Treatment purchase of services.
103F-406 Crisis purchase of services.
103F-407 Amendment and cancellation of requests.
103F-408 Modification and termination of contracts.
103F-410 Multi-term contracts.
103F-413 Interim measure for assuring continuation of services.
103F-502 Right to request reconsideration.