THE SENATE	S.B. NO.	152
THIRTY-SECOND LEGISLATURE, 2023
STATE OF HAWAII

A BILL FOR AN ACT

 

 

RELATING to insurance.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  Section 431:10C-103.5, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

     "(a)  Personal injury protection benefits, with respect to any accidental harm, means all appropriate and reasonable treatment and expenses necessarily incurred as a result of the accidental harm and which are substantially comparable to the requirements for prepaid health care plans, including medical, hospital, surgical, professional, nursing, advanced practice nursing licensed pursuant to chapter 457, dental, optometric, naturopathic medicine, chiropractic, ambulance, prosthetic services, medical equipment and supplies, products and accommodations furnished, x-ray, psychiatric, physical therapy pursuant to prescription by a medical doctor[,] or chiropractor, occupational therapy, rehabilitation, and therapeutic massage by a licensed massage therapist when prescribed by a medical doctor[.] or chiropractor."

     SECTION 2.  Section 431:10C-103.6, Hawaii Revised Statutes, is amended to read as follows:

     "§431:10C-103.6  Personal injury protection benefits tied to prepaid health care plan for description of coverage only.  (a)  The benefits provided under section 431:10C-103.5 shall be substantially comparable to the requirements for prepaid health care plans, as provided in chapter 393 and rules of the department of labor and industrial relations, pertaining to the Prepaid Health Care Act.  The reference to the Prepaid Health Care Act is only for purposes of describing the coverages and exclusions, without regard to any specific insurer or plan, and shall not be construed to transfer coverage to the prepaid health care plans.  The precise charges and utilization rates shall be as contained in the workers' compensation schedules as provided under section 431:10C-308.5, unless modified by the commissioner by rule under chapter 91.

     (b)  Chiropractic treatments shall be allowed for [not more than the lesser of the following:

     (1)  Thirty visits at no more than $75 a visit,]  plus no more than five x-rays at no more than $50 each; or

     (2)  Treatment as defined by the Hawaii State Chiropractic Association guidelines in effect on January 25, 1997.]

visits in a number not to exceed that which is deemed medically necessary.  The charges for chiropractic treatments under this section shall be tied to the charges, and any subsequent increases in charges, permissible under the workers' compensation supplemental medical fee schedule.

     (c)  Acupuncture treatments shall be allowed for [no] not more than thirty visits.  The charges for acupuncture treatments under this section shall be tied to the charges, and any subsequent increases in charges, permissible under the workers' compensation supplemental medical fee schedule.

     (d)  Naturopathic treatments shall be allowed for [no] not more than thirty visits at [no] not more than $75 a visit.

     [(e)  The combined total of naturopathic, chiropractic, and acupuncture treatments may not exceed thirty visits.

     (f)]  (e)  The benefits under section 431:10C-103.5 may be with copayment, and shall be subject to and apply the utilization requirements applicable under prepaid health care plans, under chapter 393."

     SECTION 3.  Section 431:10C-302, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

     "(a)  In addition to the motor vehicle insurance coverages described in section 431:10C-301, every insurer issuing a motor vehicle insurance policy shall make available to the insured the following optional insurance under the following conditions.  Every insurer issuing a commercial motor vehicle insurance policy shall make available to the insured the following optional insurance, except for those benefits under paragraphs (4), (5), (9), (10), and (11) under the following conditions:

     (1)  At the option of the insured, provisions covering loss resulting from damage to the insured's motor vehicle with [such] deductibles, including but not limited to collision and comprehensive deductibles of $50, $100, $250, $500, $1,000, $1,500, and $2,000, at appropriately reduced premium rates, as the commissioner, by rule, shall provide;

     (2)  At the option of the insured, compensation to the insured, the insured's spouse, any dependents, or any occupants of the insured's vehicle for damages not covered by personal injury protection benefits;

     (3)  Additional coverages and benefits with respect to any injury or any other loss from motor vehicle accidents or from operation of a motor vehicle for which the insurer may provide for aggregate limits with respect to such additional coverage so long as the basic liability coverages provided are not less than those required by section 431:10C-301(b)(1) and (2);

     (4)  At the option of the insured, an option in writing for coverage for wage loss benefits for monthly earnings loss for injury arising out of a motor vehicle accident.  Any change in the wage loss benefits coverage selected by an insured shall apply only to benefits arising out of motor vehicle accidents occurring after the date the change becomes effective.  Coverage shall be offered in multiples of $500 a month/$3,000 per accident per person, from $500 a month/$3,000 per accident to $2,000 a month/$12,000 per accident; however, nothing shall prevent an insurer from making available higher limits of coverage;

     (5)  An option in writing for minimum coverage for death benefits for death arising out of a motor vehicle accident in an amount of $25,000, to be paid to the surviving spouse, for the benefit of the spouse and dependent children, or if there are no surviving spouse or dependent children, then to the estate.  Coverage shall also be made available for increased death benefits in increments of $25,000 up to $100,000; however, nothing shall prevent an insurer from making available higher limits of coverage.  At the option of the insured, coverage for funeral expenses of $2,000 shall be made available;

     (6)  Terms, conditions, exclusions, and deductible clauses, coverages, and benefits which:

          (A)  Are consistent with the required provisions of the policy;

          (B)  Limit the variety of coverage available so as to give buyers of insurance reasonable opportunity to compare the cost of insuring with various insurers; and

          (C)  Are approved by the commissioner as fair and equitable;

     (7)  At appropriately reduced premium rates, deductibles applicable only to claims of an insured in the amounts of $100, $300, $500, and $1,000 from all personal injury protection benefits otherwise payable; provided that if two or more insureds to whom the deductible is applicable under the contract of insurance are injured in the same accident, the aggregate amount of the deductible applicable to all of them shall not exceed the specified deductible, which amount where necessary shall be allocated equally among them;

     (8)  Every insurer shall fully disclose the availability of all required and optional coverages and deductibles, including the nature and amounts, at the issuance or delivery of the policy; or, for a policy already issued on January 1, 1998, disclosure shall be made at the first renewal after January 1, 1998.  The insurer shall also disclose at issuance or renewal, as applicable, the effect on premium rates and savings of each option and deductible.  Further offers or disclosures thereafter shall be required to be included with every other renewal or replacement policy.  All elections of coverages, options, and deductibles by a named insured shall be binding upon additional insureds covered under the named insured's policy.  The purpose of this paragraph is to inform insureds or prospective insureds of the coverages under this article;

     (9)  (A)  An insurer may make available, and provide at the option of the named insured, the benefits described in section 431:10C-103.5(a) through managed care providers such as a health maintenance organization or a preferred provider organization.  The option may include conditions and limitations to coverage, including deductibles and coinsurance requirements, as approved by the commissioner.  The commissioner shall approve those conditions and limitations [which] that are substantially comparable to or exceed the coverage provided under section 431:10C-103.6;

          (B)  An insurer may make available, and provide at the option of the named insured, deductible and coinsurance arrangements whereby the recipient of care, treatment, services, products, expenses, or accommodations shares in the payment obligation;

          (C)  No deductible or coinsurance under a policy covered under [section 431:10C-302(a)(9)(A)] paragraph (9)(A) or (B) shall be applied with respect to care, treatment, services, products, or accommodation provided or expenses incurred by an insured during the first twenty-four hours in which emergency treatment has been provided or until the insured patient's emergency medical condition is stabilized, whichever is longer;

          (D)  (i)  The optional coverage prescribed in [section 431:10C-302(a)(9)(A)] paragraph (9)(A) and (B) shall apply only to the named insured, resident spouse, or resident relative; and

             (ii)  "Resident relative" means a person who, at the time of the accident, is related by blood, marriage, or adoption to the named insured or resident spouse and who resides in the named insured's household, even if temporarily living elsewhere, and any ward or foster child who usually resides with the named insured, even if living elsewhere;

          (E)  An agreement made under [section 431:10C-302(a)(9)] paragraph (9) must be a voluntary agreement between the insured and the insurer, and no insurer shall require an insured to agree to those policy provisions as a condition of providing insurance coverage.  Requiring an agreement as a precondition to the provision of insurance shall constitute an unfair insurance practice and shall be subject to the provisions, remedies, and penalties provided in article 13; and

          (F)  An insurer providing the coverages authorized in [section 431:10C-302(a)(9)(A)] paragraph (9)(A) and (B) shall demonstrate in rate filings submitted to the commissioner the savings to the insured to be realized under the plan;

    (10)  An insurer shall make available optional coverage for naturopathic, acupuncture, nonmedical remedial care, and treatment rendered in accordance with the teachings, faith, or belief of any group which relies upon spiritual means through prayer for healing; and

    (11)  An insurer may make available optional coverage for chiropractic treatment in addition to chiropractic treatment provided under section 431:10C-103.6 [for not more than the lesser of the following:

          (A)  Thirty additional visits at no more than $75 a visit; or

          (B)  Treatment as defined by the Hawaii Chiropractic Association guidelines in effect on January 25, 1997].

     The commissioner shall adopt rules, including policy limits, terms, and conditions as necessary to implement the requirements of this section."

     SECTION 4.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 5.  This Act shall take effect upon its approval.

 

INTRODUCED BY:	_____________________________

 

 

Report Title:

Motor Vehicle Insurance; Chiropractor; Naturopathic, Chiropractic, and Acupuncture Treatment; Physical Therapy; Therapeutic Massage

 

Description:

Authorizes prescriptions made by chiropractors for physical therapy and therapeutic massage treatment to qualify as a motor vehicle insurance personal injury protection benefit.  Replaces the existing cap on the number of chiropractic treatment visits that qualify for motor vehicle insurance coverage with a number of visits that are deemed medically necessary.  Amends the reimbursement amount for chiropractic treatment from $75 per visit to an amount tied to the charges, and any subsequent increases in charges, permissible under the workers' compensation supplemental medical fee schedule.  Repeals the thirty-visit cap on combined naturopathic, chiropractic, and acupuncture treatments.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.