Part I. General Provisions


432E-1 Definitions

432E-1.4 Medical necessity

432E-1.5 Licensure of managed care plan medical directors

432E-2 Conflict with other laws


Part II. General Policies

432E-3 Repealed

432E-4 Enrollee participation in treatment decisions

432E-5 Complaints and appeals procedure for enrollees

432E-6 Repealed

432E-6.5 Expedited internal appeal, when authorized;

standard for decision

432E-7 Information to enrollees

432E-8 Enforcement


Part III. Reporting and Other Provisions

432E-9 Utilization review

432E-10 Managed care plan performance measurement and

data reporting standards

432E-11 Accreditation of managed care plans

432E-12 Rules

432E-13 Annual report


Part IV. External Review of Health Insurance


432E-31 Applicability and scope

432E-32 Notice of right to external review

432E-33 Request for external review

432E-34 Standard external review

432E-35 Expedited external review

432E-36 External review of experimental or

investigational treatment adverse


432E-37 Binding nature of external review decision

432E-38 Approval of independent review organizations

432E-39 Minimum qualifications for independent review


432E-40 Hold harmless for independent review


432E-41 External review reporting requirements

432E-42 Funding of external review

432E-43 Disclosure requirements

432E-44 Rules




The amendments made to this chapter by L 2011, c 230 have a transitional effective date and are subject to the insurance commissioner's emergency rulemaking authority for conformance to the federal Patient Protection and Affordable Care Act and a conditional repeal and reenactment provision. L 2011, c 230, 14, 17.


Law Journals and Reviews


Hawai`i's Patients' Bill of Rights: Saving the Right to External Review. 28 UH L. Rev. 295 (2005).


Case Notes


As chapter 432D does not cover the field of managed care regulation and because 432D-2, 432E-1, and article 431:10A can be read together and there is no explicit language or policy reason not to give each statute effect, chapter 432D does not repeal this chapter by implication. 126 H. 326, 271 P.3d 621 (2012).


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