HI SB1449

Requires utilization review entities doing business in Hawaii to submit annual prior authorization data to the State Health Planning and Development Agency by January 31 each year, with the agency posting reporting format requirements at least 3 months before the reporting period begins.

Prohibits submission of protected health information unless the individual authorizes disclosure or authorization is not required under 45 Code of Federal Regulations section 164.512.

Establishes the Health Care Appropriateness and Necessity Working Group within the State Health Planning and Development Agency with 15 members representing insurers (5), licensed health care professionals (5), and consumers or employers (5).

Directs the working group to determine respected peer-reviewed national scientific standards, clinical guidelines, and appropriate use criteria for frequent medical treatments triggering prior authorization, assess appropriateness of requiring prior authorization, and recommend standards for third-party reviewers and decision timeframes.

Requires the working group to submit findings and recommendations to the legislature no later than 20 days before the 2026 regular session and each regular session thereafter, with recommendations being advisory only.