Bill > HB2371

This bill aims to reform Hawaii's Medicaid program by prohibiting financial risk-bearing entities, such as managed care organizations, from administering services, and instead requires the Department of Human Services to contract with administrative services organizations (ASOs) for non-risk administrative functions like claims processing and prior authorization review. The bill also mandates the creation of a Medicaid Care Coordination Program to contract with community-based programs for care coordination services, and ensures that physicians, practitioners, hospitals, and other providers are paid directly by the State's Medicaid agency on a fee-for-service basis, with payments for services being at least 100% of Medicare rates. To enhance local oversight and feedback, regional health hubs will be established in each county, and a Medicaid Stakeholder Advisory Group will be convened to support the transition and continuous improvement of the program, with reports to the Legislature and appropriations for these changes.

Housing and Urban Affairs

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=HB&billnumber=2371&year=2026