The Insurance Division oversees the Hawaii insurance industry, issues licenses, examines the fiscal condition of Hawaii-based companies, reviews rate and policy filings, and investigates insurance-related complaints.

The Executive Office on Aging (EOA) received an $800,000 federal grant in 2005 from the U.S. Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS) to develop Hawaii's Aging and Disability Resource Center (ADRC). The project is part of a national effort to establish a single-entry access point to long-term care resources.

The Hawaii State Department of Human Services (DHS) offers several programs that provide coverage of medical services for low-income Hawaii residents. The federally funded Medicaid program is the primary source for most medical assistance programs. In addition to the Medicaid programs, there are several programs that are exclusively state-funded. The Medicaid Fee-For-Service Program and the Hawaii QUEST Medicaid managed care program provide comprehensive coverage of medically necessary services, while other programs may offer coverage of specific services.

The Attorney General’s Criminal Justice Division Medicaid Fraud Control Unit investigates allegations of provider fraud committed against the state Medicaid program, and patient abuse and neglect allegations against licensed and nonlicensed care providers. The division also prosecutes confirmed allegations both criminally and civilly.

The Medicare Section is responsible for state licensing and federal certification survey activity in Hawaii and for the federal certification survey activity in the Pacific Area (American Samoa, Guam and Saipan). The office is responsible for promulgating licensing rules and developing standards as required to ensure quality of care for certain medical facilities that must be licensed by the state, including adult day health centers, ambulatory surgical centers, home health agencies, hospitals, intermediate care facilities for the mentally retarded, skilled nursing and intermediate care facilities, and clinical laboratories.

DCCA’s Consumer Resource Center provides license verification and complaint history of professionals or businesses, information on identity theft and other general consumer information.

The Executive Office on Aging (EOA) is dedicated to ensuring the well-being of the more than 230,000 older adults who live in Hawaii, as well as of their caregivers. It is the designated lead agency in the coordination of a statewide system of aging and caregiver support services in the state of Hawaii, as authorized by federal and state laws.

The mission of the Hawaii State Department of Health is to protect and improve the health and environment for all people in Hawaii. The Department of Health oversees the Executive Office on Aging and has a special section devoted to Medicare.

AARP, formerly the American Association of Retired Persons, is a nonprofit, nonpartisan organization with a membership that advocates for people ages 50 and older. Since 1958, AARP has lobbied for senior issues, including the passage of Medicare in 1965. AARP offers support from staffed offices in all 50 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands.

The Better Business Bureau of Hawaii established a Senior Scam Hotline to help protect seniors from being victimized by fraudulent offers and other scams. Seniors may call with questions about the legitimacy of offers and propositions made to them.

Wisconsin Physicians Service (WPS) is a Medicare Administrative Contractor (MAC), a company contracted by the CMS to process Medicare claims. WPS processes Medicare Part A and Part B payments and claims for Jurisdiction 5, which consists of Iowa, Kansas, Missouri and Nebraska. WPS also administers Part A and Part B legacy contracts. The Part A legacy contracts are former Mutual of Omaha providers who will eventually transition to Jurisdiction 1 (covered by Palmetto Government Benefit Administrators). They cover Hawaii, Delaware and New York. The Part B legacy contracts cover Illinois, Michigan, Minnesota and Wisconsin.

The Area Agencies on Aging (AAA) were established under the Older Americans Act (OAA) Comprehensive Services Amendments in 1973 to respond to the needs of Americans 60 and older in every local community. The amendments added a new Title V, which authorized grants to local community agencies in every state. The AAAs provide a range of options that allow older adults to choose the home- and community-based services and living arrangements that suit them best. Each county in the state of Hawaii has an Area Agency on Aging.

The Sage PLUS Program, called the State Health Insurance Assistance Program (SHIP) in most other states, is a national program that offers counseling and assistance to people with Medicare and to their families. Coordinators provide counseling on Medicare benefits, Medicare Prescription Drug Plans (Part D), Social Security, Medicaid and veterans' benefits. SHIP, formerly the Information, Counseling and Assistance (ICA) grants program, was created under section 4360 of the Omnibus Budget Reconciliation Act of 1990. This act authorized the Centers for Medicare & Medicaid Services (CMS) to make grants to states for health advisory services programs for people with Medicare.

Long-term care ombudsmen are advocates for residents of nursing homes and assisted living facilities. They resolve complaints and educate seniors and long-term care providers about their rights and good care practices. They also provide information to the public on nursing homes and other long-term care facilities and services, residents' rights, and legislative and policy issues. In 1978, an amendment to the federal Older Americans Act required every state to have an ombudsman program that addresses complaints and advocates for improvements in the long-term care system. The ombudsman program is administered by the Administration on Aging (AoA).

The Senior Medicare Patrol (SMP) program helps Medicare and Medicaid beneficiaries avoid, detect and prevent health care fraud. The goal is to protect older people and to preserve the integrity of the Medicare and Medicaid programs. The federal program was created in 1996 by the Health Insurance Portability and Accountability Act (HIPAA) and amended in 2006 by Titles II and IV of the Older Americans Act.

Mountain-Pacific Quality Health is the Quality Improvement Organization (QIOs) for Hawaii, QIOs are private, mostly not-for-profit organizations, staffed by doctors and other health care professionals, who are trained to review medical care, to help beneficiaries with complaints about the quality of care and to implement improvements in the quality of care available throughout the spectrum of care. QIOs are required under Sections 1152-1154 of the Social Security Act.

Before serving as president and CEO of The Queen’s Health Systems and The Queen’s Medical Center, Art Ushijima was a health care administrator in the U.S. Air Force Medical Service Corps. He was also the executive director of St. Mary’s Hospital in Kansas, Mo. Ushijima is a member of the American Public Health Association.

In addition to serving as the chairman and CEO of Kaiser Foundation Hospitals and Kaiser Foundation Health Plan Inc., George C. Halvorson chairs the International Federation of Health Plans. He also cochairs the Institute for Healthcare Improvement Annual National Forum on Quality Improvement in Health Care. Before joining Kaiser, Halvorson was president and CEO of HealthPartners in Minneapolis. He has written several health care reform books, the most recent titled “Health Care Will Not Reform Itself: A User’s Guide to Refocusing and Reforming American Health Care.”

Gary K. Kajiwara has served as the president and CEO of Kuakini Medical Center since 1990. He was previously the assistant vice president of the center. In addition to his work with Kuakini Medical Center, Kajiwara is a member of the board of directors for the Hawaii Medical Service Association, an independent licensee of the Blue Cross and Blue Shield Association. He earned one master’s degree in business and another in public health from the University of Hawaii.

Jerry J. Correa Jr. became president and CEO of the St. Francis Healthcare System of Hawaii in January 2012. He previously served as St. Francis’ chief operating officer, overseeing the operational and financial performance of various facilities, including St. Francis Hospice, St. Francis Home Care Services and the Franciscan Adult Day Center. Correa is the first layperson (not a Sister of St. Francis) to serve as the CEO of St. Francis since its founding in 1927.

The scope of this committee shall be those programs relating to financial assistance; medical assistance; vocational rehabilitation; social welfare services; and the general well-being of the state's elderly and youth, including juvenile correctional services.

The purview of this committee includes those programs relating to: public assistance; MedQuest; youth services; early childhood education and care programs under the Department of Human Services; vocational rehabilitation; long-term care; programs relating to the promotion of the general well-being of Hawaii's youth, families and elderly population; and homeless and public housing.

The scope of this committee shall be those programs relating to general health; maternal and child care; communicable diseases; dental health; medical and hospital services; mental health; mental retardation; hospitals; and community health care facilities.

The purview of this committee includes those programs relating to: general health; maternal and child health; communicable diseases; dental health; medical and hospital services; mental health; developmental disabilities; and hospitals.