CHAPTER 432E

[PATIENTS' BILL OF RIGHTS AND RESPONSIBILITIES ACT]

 

           Part I.  General Provisions

Section

     432E-1 Definitions

   432E-1.4 Medical necessity

   432E-1.5 Licensure of managed care plan medical directors

     432E-2 Conflict with other laws

     432E-3 Access to services

     432E-4 Enrollee participation in treatment decisions

 

           Part II.  General Policies

     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     432E-6 Repealed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

                     Determinations

    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

            determinations

    432E-37 Binding nature of external review decision

    432E-38 Approval of independent review organizations

    432E-39 Minimum qualifications for independent review

            organizations

    432E-40 Hold harmless for independent review

            organizations

    432E-41 External review reporting requirements

    432E-42 Funding of external review

    432E-43 Disclosure requirements

    432E-44 Rules

 

Note

 

  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.