HB857

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

Hawaii HB857 requires accident and health insurers, mutual benefit societies, and health maintenance organizations to adopt prior authorization policies equivalent to Medicare guidelines. Insurers must establish criteria for approving or denying requests, including time frames for decision-making, approval criteria, required documentation, and duration. Insurers must also provide peer-to-peer reviews and allow basic patient information to be shared prior to such reviews. Insurers must publish criteria and request processes on their websites and notify policyholders of any changes.