Bill > HB2537

This bill, known as the "Hawaii Patients' Bill of Rights of 2025," aims to modernize and strengthen patient protections by ensuring timely access to healthcare, improving transparency in decision-making processes, and safeguarding patient information. Key provisions include establishing rights to prompt referrals and access to specialists, mandating faster decisions on prior authorization requests (one business day for urgent, three for non-urgent), and requiring health carriers to clearly explain adverse decisions and provide accessible appeal processes. The bill also addresses the use of "automated decision support tools," which are defined as artificial intelligence or algorithm-based systems used in health care decisions, by requiring disclosure of their use, independent review by a clinician if they materially contribute to an adverse decision, and annual review of the tools' governance and validation by the insurance commissioner. Furthermore, it enhances data protection by requiring health carriers to implement safeguards for protected health information, similar to federal standards, and to promptly notify the insurance commissioner and enrollees of any data breaches, including those involving "offshoring contracts" (outsourcing services outside the U.S.). The bill also mandates quarterly reporting on network adequacy, including provider ratios and wait times, and prohibits health carriers from retaliating against providers who advocate for patients or file complaints. Finally, it expands the enforcement authority of the Insurance Commissioner, allowing for audits, penalties, restitution, and other actions to ensure compliance with these new patient rights.

Health and Social Services

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=HB&billnumber=2537&year=2026