Hawaii HB857 mandates insurers to align their prior authorization criteria with Medicare guidelines.

Hawaii HB857 requires all accident and health or sickness insurers, mutual benefit societies, and health maintenance organizations to adopt policies, procedures, and criteria for approving or denying requests for prior authorization that match Medicare guidelines. Insurers must publish these criteria and the request process on their websites and notify policyholders of any changes. Insurers cannot retroactively deny payment for services that received prior authorization, except in cases of fraud or intentional misrepresentation.

Hawaii HB857 mandates insurers to align their prior authorization criteria with Medicare guidelines.

Hawaii HB857 requires all accident and health or sickness insurers, mutual benefit societies, and health maintenance organizations to adopt policies, procedures, and criteria for approving or denying requests for prior authorization that match Medicare guidelines. Insurers must publish these criteria and the request process on their websites and notify policyholders of any changes. Insurers cannot retroactively deny payment for services that received prior authorization, except in cases of fraud or intentional misrepresentation.