HI HB954

Creates the "Ensuring Transparency in Prior Authorization Act" establishing a comprehensive regulatory framework for health insurance prior authorization in Hawaii

Requires utilization review entities to post prior authorization requirements and clinical criteria on their websites, provide 60 days written notice before implementing new requirements, and publish approval/denial statistics publicly

Sets strict timelines for prior authorization decisions: 48 hours for non-urgent services (automatic approval if deadline missed), 24 hours for urgent services, and 60 minutes for post-emergency stabilization services

Prohibits prior authorization requirements for pre-hospital transportation, emergency health care services, and medications for opioid use disorder

Exempts health care providers from prior authorization requirements for specific services if 80% or more of their requests were approved in the previous 12-month period

Mandates prior authorizations remain valid for minimum one year, with chronic/long-term condition authorizations valid for treatment duration; requires new insurers to honor prior authorizations for at least 90 days

Requires utilization review entities to submit annual reports to the Insurance Commissioner by March 1, with the Commissioner submitting summary reports to the legislature by May 1 each year