HI SR6

Urges the Administrator of the State Health Planning and Development Agency to establish a working group on health insurance reform to address prior authorization requirements that delay health care delivery.

Working group membership consists of 15 members: 5 representing the insurance industry (selected by Hawaii Association of Health Plans), 5 representing licensed health care professionals (2 from Hawaii Medical Association, 2 from Healthcare Association of Hawaii, 1 from Hawaii State Center for Nursing), and 5 representing consumers or employers (2 from Employer-Union Health Benefits Trust Fund, 1 from Statewide Health Coordinating Council, 1 from Hawaii Primary Care Association, 1 from Papa Ola Lokahi).

Requests ex-officio membership from the Director of Health, Insurance Commissioner, and Administrator of the Med-QUEST Division of the Department of Human Services.

Working group must examine federal and state laws and other states' regulations regarding prior authorization response times (24 hours for urgent care, 48 hours for non-urgent), medication authorization validity periods (minimum one year), chronic condition treatment authorizations, specialty-matched reviewers, retroactive denial procedures, data transparency, plan transitions, and volume reduction criteria.

Working group must submit findings, recommendations, and proposed legislation to the Legislature no later than 20 days before the Regular Session of 2026.