HOUSE OF REPRESENTATIVES
TWENTY-EIGHTH LEGISLATURE, 2015
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO THE HAWAII HEALTH CONNECTOR.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Section 432F-2, Hawaii Revised Statutes, is amended to read as follows:
§432F-2[ ]] Health
care provider network adequacy. (a) On or before January 1 of each
calendar year, each managed care plan shall demonstrate the adequacy of its
provider network to the commissioner. A provider network shall be considered
adequate if it provides access to sufficient numbers and types of providers to
ensure that all covered services will be accessible without unreasonable delay,
after taking into consideration geography. The commissioner shall also
consider any applicable federal standards on network adequacy. A certification
from a national accreditation organization shall create a rebuttable
presumption that the network of a managed care plan is adequate. This presumption
may be rebutted by evidence submitted to, or collected by, the commissioner.
(b) A managed care plan that does not have a certification from a national accreditation organization may submit to the commissioner a plan to become accredited by a national accreditation organization within a period of two years if the managed care plan has provided sufficient evidence that its network is reasonably adequate at the time of submission of the plan. The commissioner shall also consider any applicable federal standards on network adequacy. The commissioner may extend the period of time for accreditation.
(c) The commissioner shall approve or disapprove a managed care plan's annual filing on network adequacy. If the commissioner deems the filing incomplete, additional information and supporting documentation may be requested. A managed care plan shall have sixty days to appeal an adverse decision by the commissioner in an administrative hearing pursuant to chapter 91.
(d) To enable the commissioner to
determine the network adequacy for qualified health plans to be listed with the
Hawaii health connector under section 435H-11, the commissioner may request
that a managed care plan demonstrate the adequacy of its provider network at
the time that it files its health plan benefit document with the commissioner. (e)] (d) This section shall apply to any managed care plan qualified as a prepaid
health care plan pursuant to chapter 393."
SECTION 2. Chapter 435H, Hawaii Revised Statutes, is repealed.
SECTION 3. This Act shall take effect upon its approval.
Hawaii Health Connector
Repeals the Hawaii Health Connector. (HB726 HD2 PROPOSED)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.