THE SENATE	S.C.R. NO.	43
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII

SENATE CONCURRENT

RESOLUTION

 

 

strongly supporting and recommending the implementation of the revised 2025 hawaii patient bill of rights.

 

 

 

     WHEREAS, Hawaii pioneered employer-supported health insurance through the Prepaid Health Care Act of 1974; however, the State continues to face severe physician, nurse, and dentist shortages, with over thirty-five percent of the population residing in federally designated Health Professional Shortage Areas--the highest percentage in the nation; and

 

     WHEREAS, the University of Hawaii Health Research Center found that forty-two percent of surveyed physicians reported patient harm or serious adverse events attributable to prior authorization delays or denials, emphasizing a need for streamlined insurance processes; and

 

     WHEREAS, recent increases in claims denials, particularly those driven by automated or artificial intelligence (AI)-based systems, underscore the necessity for greater transparency, specialist review, and patient-friendly appeals mechanisms; and

 

     WHEREAS, the original Hawaii Patient Bill of Rights, enacted over twenty-five years ago, now requires substantial updates to address modern challenges, such as AI-driven denials, telehealth accessibility, data-offshoring risks, and persistent network inadequacies on the neighbor islands and in rural areas; and

 

     WHEREAS, patients, health care providers, and cybersecurity experts cite the need for robust data protection measures that accommodate legitimate offshoring services while maintaining Health Insurance Portability and Accountability Act-equivalent safeguards, timely breach notifications, and strong enforcement; and

 

     WHEREAS, the Insurance Commissioner's office needs expanded authority, resources, and reporting mechanisms to effectively audit, investigate, and sanction noncompliant insurers or billing entities, ensuring consistent and accountable enforcement of patients' rights; and

 

     WHEREAS, the Revised 2025 Hawaii Patient Bill of Rights is an essential modernization step that prioritizes patient autonomy, transparent healthcare, timely access, robust data protection, AI accountability, and real enforcement--all while recognizing the practical realities of insurers, providers, and patients in a rapidly evolving healthcare landscape; now, therefore,

 

     BE IT RESOLVED by the Senate of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2025, the House of Representatives concurring, that this body strongly supports and recommends the implementation of the following Revised 2025 Hawaii Patient Bill of Rights:

 

            Foreword and Definitions

 

1. Purpose: This Bill of Rights modernizes patient protections to address AI-based coverage decisions, data security risks, and ongoing provider shortages in Hawaii.

 

2. Definitions:

 

o AI or Automated Decision System: Any algorithmic or software-based platform that can autonomously generate or recommend coverage determinations without direct human supervision.

o HIPAA-equivalent Security: A standard of data protection meeting or exceeding requirements set forth in 45 C.F.R. Parts 160 and 164 (HIPAA Privacy and Security Rules).

o Urgent vs. Non-Urgent: Urgent requests are those where delays could seriously jeopardize a patient's health, life, or overall well-being; non-urgent requests include all other prior authorizations not qualifying as urgent.