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Hawaii committees advance hospital cost-reporting bill after agencies warn of complexity
Summary
The House Health and Consumer Protection & Commerce committees advanced HB2501 on Feb. 11, requiring hospitals to report costs tied to Medicare and uninsured patients; the Department of Health and hospital systems warned the data request is complex and may require new capacity, and the committee adopted amendments clarifying net-loss reporting.
The House Committees on Health and on Consumer Protection & Commerce voted Feb. 11 to advance HB2501, a bill that would require hospitals to report costs associated with Medicare and uninsured patients.
Supporters and agency witnesses said the measure aims to improve transparency about how uncompensated care and reimbursement shortfalls affect hospital finances, but several witnesses cautioned implementation will be technically difficult. "This is going to be a complicated, complex task," Lord Kim of the Department of Health told the committees, adding the department lacks some of the specialized health-financing expertise the bill would require and would likely need to contract to perform the work.
Hospital systems expressed willingness to cooperate while underscoring the challenge. Edward Hsu of Hawaii Health Systems Corporation and a representative of The Queen's Health System said they "stand on" written testimony and offered to work with DOH and the legislature on data and definitions. A provider-association witness explained that federal and state matching programs — including a provider tax program — already shift funds among hospitals and that the special fund distributions are based on Medicaid volume.
During questioning, members pressed witnesses for concrete numbers and how current state support functions. A hospital-affiliated witness described the provider-tax mechanism: hospitals and nursing facilities contribute to a special pool that draws additional federal dollars and is redistributed, typically with greater shares for providers that treat more Medicaid patients. The witness provided a ballpark net-benefit range of roughly $130–150 million for hospitals and about $20 million for nursing facilities but said the committees would be provided precise figures after follow-up research.
In decision-making, the committee adopted the chair's recommendation to pass HB2501 with amendments intended to clarify the reporting metric. Committee leaders said they would change statutory language to require reporting of the hospitals' net loss (the amount not reimbursed), not simply gross expenditures, and add an effective date to keep the bill alive.
The committee did not specify exact implementation timelines; sponsors and agency staff said follow-up work to define reporting templates and potential contracting needs would be necessary before data collection. The measure will move forward with the adopted amendments for further floor or chamber action.
