Bill > HB1092

This bill amends Hawaii's Medicaid third-party liability laws to comply with federal requirements in the 2022 Consolidated Appropriations Act. Specifically, the bill modifies the existing legal requirements for health insurers when dealing with Medicaid claims by mandating that insurers respond to state inquiries about health care claims within 60 calendar days (if submitted within three years of service), and prohibiting insurers from denying claims solely based on lack of prior authorization. The bill introduces a new provision requiring insurers to accept prior authorizations from the state medical assistance program as if they were the insurer's own authorization. These changes are designed to streamline the claims process and ensure that Medicaid recipients can more easily access health care services by reducing administrative barriers. The bill reflects federal efforts to simplify and standardize how third-party payers interact with state Medicaid programs, with the goal of making health care more accessible and reducing unnecessary bureaucratic obstacles.

Business and Industry, Health and Social Services

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=HB&billnumber=1092&year=2026