HI SB1449

Requires all utilization review entities operating in Hawaii to submit annual prior authorization data to the State Health Planning and Development Agency by January 31 each year, with the agency publishing findings and recommendations by March 1

Establishes the Health Care Appropriateness and Necessity Working Group, a 15-member body with representatives from insurance industry (5), health care professionals (5), and consumers/employers (5), plus three ex-officio advisors from state agencies

Working group must identify respected peer-reviewed scientific standards, clinical guidelines, and appropriate use criteria for treatments most frequently triggering prior authorization, and assess whether prior authorization is appropriate for each

Working group will recommend standards for third-party reviewers' specialty expertise, appropriate timeframes for urgent and standard authorization decisions, and treatments for chronic conditions where authorization may remain valid for the full treatment duration

Working group recommendations are advisory only, with the agency required to report annually to the legislature on adoption rates and impacts; bill has placeholder effective date of July 1, 3000