Healthcare (Primary Care)

Establishes the Primary Care Providers Working Group within the State Health Planning and Development Agency to address issues relating to, and develop recommendations for the stabilization of, primary care services in Hawaii. Requires the Working Group to make a report to the Legislature. Sunsets the Working Group on 6/30/2027. Effective 1/1/2050. (SD1)

Requires all health carriers to allocate, initially, not less than 6% of the carrier's total medical expenditures to primary care providers, with the percentage increasingly incrementally to 12%. Requires health carriers to pay primary care providers directly, rather than through administrative mechanisms. Places restrictions on downcoding and claim modifications. Requires health carriers to ensure access to primary care in rural areas, including access to Primary Care Access Visits and Community Access Primary Care Sites. Requires Insurance Commissioner to administer requirements established in bill. Requires the Department of Human Services Med-QUEST Division to apply the Act, to the extent permitted by federal law and subject to any federal approvals, to Medicaid managed care organizations. Requires reports. Requires the Auditor to evaluate the impact of the Act on various metrics 3 years after the measure's effective date. Establishes the primary care stabilization special fund.

Amends the Healthcare Preceptor Tax Credit to remove language limiting access only to those practicing in primary care, to add licensed dietitians, physician assistants, and social workers as eligible preceptors and students, and to include residency and followship programs. Adds the Director of Health and a representative of residency programs with eligible students to the Preceptor Credit Assurance Committee. Applies to taxable years beginning after 12/31/2026.

SB 1647 allocates state funds to the Department of Human Services to directly pay primary care physicians for services provided to Med-QUEST recipients. This bill specifically affects low-income Hawaii residents enrolled in Med-QUEST (the state's Medicaid program) and the primary care doctors who treat them. The key mechanism is a funding stream that shifts payment responsibility from physicians to the state agency, ensuring doctors receive reimbursement for care delivered to these patients. The bill aims to streamline payments without changing eligibility or coverage for Med-QUEST beneficiaries.

Expands the definitions of "preceptor" and "volunteer-based supervised clinical training rotation" to improve accessibility for providers to receive income tax credits for acting as preceptors, including removing "primary care" from the criteria to qualify as a preceptor. Adds dieticians, physician assistants, and social workers to the list of preceptors and eligible students. Expands eligibility for the tax credit to include accredited residency programs that require preceptor support. Adds the Director of Health and residency programs with eligible students to the Preceptor Credit Assurance Committee. Applies to taxable years beginning after 12/31/2025. (SD1)