The Honolulu Star Bulletin reports Hawaii Medical Service Association (“HMSA”) will increase its rates for large-employer groups of 100 or more employees by 9.2 percent, the steepest increase since 2002 when the rates were raised 12.9 percent. HMSA, the state’s largest health insurers, says although hospital admissions are not increasing, medical payments to hospitals and physicians substantially increased last year.
Insurance Commissioner J.P. Schmidt said he is concerned about inadequate reimbursements to providers. Schmidt believes HMSA has one of the lowest reimbursements levels in the country for hospitals. Reimbursements are typically a percentage above Medicare rates, but Schmidt believes the federal government gives Hawaii an unfairly low Medicare reimbursement rate. By using Medicare rates as a guide, HMSA’s payments are low. Some doctors believe HMSA is shifting money to pay for certain procedures while decreasing the amount of reimbursement for other procedures.
