Bill proposed as new exam rule frustrates physicians

HONOLULU (AP) — Lawmakers are pursuing a bill aimed at the state’s largest health insurer’s new imaging exam rule that is frustrating physicians.

Arizona-based National Imaging Associates Inc. started deciding MRI and other imaging exam requests by all physicians in the Hawaii Medical Service Association network on Dec. 1.

Previously, waivers allowed some doctors to avoid the preauthorization. HMSA chief medical officer Dr. Mark Mugiishi told lawmakers that waivers have been restored to 22 of 58 providers. The network includes more than 2,000 doctors.

“Preauthorization programs for advanced imaging are commonplace because advanced imaging has become a problem of over-utilization in our country and something that really does need to be addressed so that we can spend our health care dollars on things that really matter and are necessary for our population,” Mugiishi said.

Hawaii Medical Association president Dr. Scott McCaffrey told a Senate committee Thursday that nothing should keep physicians from early and accurate diagnoses. The association represents 1,100 physicians.

“In health care, moments really do matter,” McCaffrey said. The bill was introduced after a Star-Advertiser report on complaints that the policy impedes tests and impacts patients. It seeks to ban requirements that delay medical services and make insurers liable for civil damages resulting from preauthorization waits.

Senate Commerce, Consumer Protection and Health Committee chairwoman Sen. Roz Baker asked the health insurer and the doctors in its network to compromise before a decision is made on the bill.

Hilo radiologist Dr. Scott Grosskreutz said that in a closed-door session after the hearing, officials with the medical service association decided to meet with the Hawaii Medical Association to discuss a compromise.

“The physicians are hopeful after meeting with HMSA that we can find a better way to approve tests so that there are no longer delays in patient care,” he said.