Report Title:

Health insurance complaints and appeals procedures

Description:

Amends chapter 432E, Hawaii Revised Statutes, to increase the number of days that managed care plans have to determine the outcome of complaints not classified as expedited from 45 to 60.

HOUSE OF REPRESENTATIVES

H.B. NO.

2138

TWENTY-SECOND LEGISLATURE, 2004

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to managed care plan complaints and appeals procedures.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. Section 432E-5, Hawaii Revised Statutes, is amended by amending subsection (d) to read as follows:

"(d) A managed care plan shall send notice of its final internal determination within [forty-five] sixty days of the submission of the complaint to the enrollee, the enrollee's appointed representative, if applicable, the enrollee's treating provider, and the commissioner. The notice shall include the following information regarding the enrollee's rights and procedures:

(1) The enrollee's right to request an external review;

(2) The sixty-day deadline for requesting the external review;

(3) Instructions on how to request an external review; and

(4) Where to submit the request for an external review."

SECTION 2. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 3. This Act shall take effect upon its approval.

INTRODUCED BY:

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