HB 1028 Summary

• Amends Hawaii insurance regulations to require mammography coverage terms at least as favorable to insured persons as those applicable to other radiological examinations, including dollar limits, deductibles, and copayments.

• Revises external review procedures for health carriers, mutual benefit societies, and health maintenance organizations to align with the National Association of Insurance Commissioners Uniform Health Carrier External Review Model Act.

• Grants the insurance commissioner authority to determine eligibility for external review notwithstanding a health carrier's initial ineligibility determination and require referral for external review.

• Requires health carriers to provide independent review organizations with all documents and information considered in adverse actions plus any documents related to external review requests received by the carrier.

• Takes effect January 1, 2024.