HI HB2371

Prohibits Hawaii from contracting with financial risk-bearing entities (managed care organizations) for Medicaid administration beginning July 1, 2026, with all existing managed care contracts terminating by December 31, 2026

Requires the Department of Human Services to contract with administrative services organizations for non-risk functions including claims processing, prior authorization review, provider credentialing, customer service, and data analytics

Establishes a Medicaid Care Coordination Program with community-based teams providing patient navigation, chronic disease management, behavioral health integration, and culturally competent outreach, funded through fixed payments rather than capitation

Mandates direct fee-for-service payments from the state to physicians and hospitals at minimum 100% of Medicare rates, with separate fixed care coordination fees for designated primary care providers

Creates regional health hubs in each county to monitor community health needs and assess disparities, meeting at least quarterly, plus a Medicaid Stakeholder Advisory Group to oversee the transition process