HI HB1092

Amends Section 431L-2.5 of Hawaii Revised Statutes to comply with federal requirements under Section 202 of the Consolidated Appropriations Act, 2022 regarding Medicaid third party liability.

Requires responsible third party payers to respond to state Medicaid inquiries within 60 calendar days (previously unspecified timeframe) regarding health care claims submitted up to three years after service provision.

Prohibits third party payers from denying claims solely based on lack of prior authorization, requiring them to accept state medical assistance program authorization as equivalent to their own prior authorization requirements.

Allows states to submit Medicaid claims within three years of service provision and to enforce rights up to six years from submission without denial based on submission date, claim format, documentation issues, or prior authorization failures.

Takes effect July 1, 3000.