HCR 137 and Hawaiʻi’s Clean Claims Statute: Why Timely Health Care Claim Payment Matters

Hawaiʻi already has a law that requires timely payment of clean health care claims. HCR 137 exists because too many providers still experience harmful reimbursement delays, and those delays do real damage to local medical practices and to patient access. The resolution asks health maintenance organizations in Hawaiʻi to follow the State’s Clean Claims Statute and to be held accountable when they do not. The resolution itself states that delayed reimbursement harms health care providers, patients, consumers, and especially rural and underserved communities. (Hawaii State Legislature)

What is HCR 137?

HCR 137 is a 2026 Hawaiʻi House Concurrent Resolution focused on timely reimbursement of health care claims. It does not create a brand-new payment deadline. Instead, it points back to existing Hawaiʻi law and asks that health maintenance organizations adhere to that law and be held accountable for timely payment. In other words, the issue is not whether Hawaiʻi has a prompt-payment rule. The issue is whether that rule is being enforced consistently enough to protect providers and patients. (Hawaii State Legislature)

What does Hawaiʻi’s Clean Claims Statute require?

Hawaiʻi’s Clean Claims Statute is HRS § 431:13-108. As described in HCR 137, uncontested claims must be reimbursed within thirty days after receipt, or within fifteen days if the claim was submitted electronically. Legislative materials from Hawaiʻi’s 2026 session also describe late clean claims as being subject to fifteen percent annual interest. At the same time, the DCCA Insurance Division is the state office that oversees the insurance industry and investigates insurance-related complaints. (Hawaii State Legislature)

Why does this matter so much?

Because delayed reimbursement is not a minor paperwork problem. For a small or independent practice, a late payment becomes a cash-flow problem immediately. Payroll is still due. Rent is still due. Utilities, supplies, taxes, and vendor bills are still due. Providers still have to see patients and keep staff employed even when payment for care that has already been delivered is delayed. HCR 137 recognizes exactly that point by stating that providers may be forced to cover payroll and operating expenses while waiting for reimbursement, and that repeated delays can contribute to business distress, closure, and reduced access to care. (Hawaii State Legislature)

What does delayed payment look like on the ground?

For providers, this issue is deeply personal. I have nearly been driven out of business repeatedly by delays in payment. When reimbursement that should have arrived within the timelines set by Hawaiʻi law does not arrive, I still have to meet payroll, cover operating expenses, and keep caring for patients. That means the financial risk is shifted away from the insurer and onto the provider who already delivered the care. In real life, that is how delayed reimbursement threatens practice survival.

Why is HCR 137 needed if the law already exists?

Because a law on the books is not the same thing as meaningful accountability. HCR 137 says enforcement of HRS § 431:13-108 appears to occur infrequently and is often driven by after-the-fact complaints instead of consistent oversight. Hawaiʻi’s DCCA does provide a complaint pathway, but a complaint-driven system still leaves providers carrying the financial burden first and seeking help only after the damage is already underway. That is one reason HCR 137 matters: it frames timely reimbursement as a statewide patient-access issue, not just a private billing dispute. (Hawaii State Legislature)

How do other states handle prompt payment accountability?

Other states show that deadlines alone are not enough. California pairs claim-payment rules with fifteen percent interest on late complete claims, provider dispute timelines, and quarterly reporting when a plan fails to reimburse at least ninety-five percent of complete claims with the correct payment, interest, and penalties due. Texas uses prompt-pay deadlines, requires claims and payment reporting through its Clean Claims portal, and imposes substantial penalties for late or underpaid clean claims. New Jersey requires prompt payment of clean claims, late interest, and internal and external appeal mechanisms for providers. Hawaiʻi is not asking for something unusual by expecting compliance and accountability. Other states already use stronger oversight tools. (California DMHC)

What should accountability look like in Hawaiʻi?

At a minimum, accountability should mean proactive monitoring of whether claims are paid on time, not just waiting for providers to complain after the fact. It should mean enforcing the consequences already tied to late payment, tracking repeat problems, and giving lawmakers and the public a clearer picture of whether plans are complying with HRS § 431:13-108. California, Texas, and New Jersey all show that reporting, appeals, and measurable enforcement tools can be part of a real prompt-pay system instead of a paper promise. (Hawaii State Legislature)

Why should legislators and the public care?

Because delayed reimbursement does not stay inside the billing office. When providers are forced to finance insurer delays, the result can be reduced staffing, reduced services, financial distress, or closure. HCR 137 explicitly connects reimbursement delays to threats to patient access and to disproportionate harm in rural and underserved communities. In a state where access to care is already fragile in many places, Hawaiʻi cannot afford to treat timely payment as optional. (Hawaii State Legislature)

The bottom line

HCR 137 is a straightforward request: follow Hawaiʻi law and enforce it. Hawaiʻi already has a Clean Claims Statute. Uncontested claims already have payment deadlines. The Legislature is right to ask whether those deadlines are being honored in practice and whether providers are being protected when they are not. Lawmakers should support HCR 137 and continue pushing for consistent oversight and real accountability so that healthcare providers can stay open and patients can keep getting care. (Hawaii State Legislature)

FAQ

What is HCR 137 in Hawaiʻi?

HCR 137 is a 2026 Hawaiʻi House Concurrent Resolution asking health maintenance organizations in the state to follow and be held accountable for timely reimbursement of health care claims under Hawaiʻi’s Clean Claims Statute. (Hawaii State Legislature)

What is Hawaiʻi’s Clean Claims Statute?

Hawaiʻi’s Clean Claims Statute is HRS § 431:13-108, which sets payment timelines for uncontested health care claims and is cited directly in HCR 137. (Hawaii State Legislature)

How fast must clean claims be paid in Hawaiʻi?

As described in HCR 137, uncontested claims must be reimbursed within thirty days after receipt, or within fifteen days if they were submitted electronically. (Hawaii State Legislature)

Does HCR 137 change Hawaiʻi law?

No. HCR 137 is a resolution asking for adherence to and accountability under existing law. It does not itself create a new statute or a new payment deadline. (Hawaii State Legislature)

Why does timely reimbursement matter?

Because delayed payment can destabilize medical practices, threaten payroll and operations, and reduce patient access to care, especially in rural and underserved communities. (Hawaii State Legislature)