™Your Policy Risk Impact Agent
16 chapters · 1,757 sections in this title.
HRS §432E-1 Definitions
13.5K chars
PART I. GENERAL PROVISIONS §432E-1 Definitions. As used in this chapter, unless the context otherwise requires: "Adverse action" means an adverse determination or a final adverse determination. "Adverse determination" means a determination by a health carrier or its designated ut…
HRS §432E-1.4 Medical necessity
7.2K chars
§432E-1.4 Medical necessity. (a) For contractual purposes, a health intervention shall be covered if it is an otherwise covered category of service, not specifically excluded, recommended by the treating licensed health care provider, and determined by the health plan's medical d…
HRS §432E-1.5 Licensure of managed care plan medical directors
0.3K chars
§432E-1.5 Licensure of managed care plan medical directors. The medical director of any managed care plan providing services in the State shall hold an unlimited license to practice medicine or osteopathic medicine in the State pursuant to chapter 453. [L 1999, c 273, §1; am L 20…
HRS §432E-10 Managed care plan performance measurement and data reporting standards
4.1K chars
§432E-10 Managed care plan performance measurement and data reporting standards. (a) It is the policy of this State that all managed care plans shall adopt and comply with nationally developed and promulgated standards for measuring quality, outcomes, access, satisfaction, and ut…