Wednesday, December 23, 2009

Costly benefits may be covered (Honolulu Advertiser)

Hawai'i is proposing a new free health plan that will cover critical dialysis and chemotherapy treatments for legal migrants from independent Pacific nations.

Migrants from Micronesia, the Marshall Islands and Palau had protested the Hawaii Department of Human Services' move toward removing the costly treatments it provides for free from its health plan covering about 7,000 adult noncitizens. A federal judge's Sept. 1 ruling prevented Hawai'i from implementing that plan.

The new Basic Health Hawaii program announced Monday includes those treatments while still saving the cash-strapped state about $8 million in taxpayer money. The old plan would have produced $15 million in savings.

"When we announced plans for Basic Health Hawai'i last summer, Pacific migrants and others were concerned that the program did not cover kidney dialysis and chemotherapy," Department of Human Services Director Lillian Koller said. "We worked with health care providers and the federal government to cover dialysis as an emergency service through Medicaid. We also expanded Basic Health Hawai'i to cover brand-name drugs, including chemotherapy drugs. This should alleviate any concerns."

The migrants are beneficiaries of compacts of free association, under which the United States was granted the right to use defense sites in exchange for financial assistance and migration rights. The agreements stemmed from U.S. nuclear weapons tests in Pacific islands a half-century ago.

Coverage includes four medications, 12 outpatient doctor visits, 10 hospital days, six mental health visits, three procedures and emergency medical and dental care.

Lifesaving dialysis treatments will be offered three times a week, and chemotherapy treatments are included along with the drugs, according to the department.

Pacific islander migrants may be suspicious of the changes because Hawai'i tried to remove some treatments without notice or public hearings, said Victor Geminiani, executive director for Lawyers for Equal Justice.

"It's one more step in a very faulty process, a process that from the beginning has been poorly set up," Geminiani said. "They're just now going back and trying to dot the i's and cross the t's for a lot of things they should have done a long time ago."

This time, there will be a comment period and a public hearing Jan. 25.

Geminiani said he wants to use the time to ensure that enough dialysis sessions are included, chemo treatments are adequate, and transportation is provided for the poor to visit doctors.

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