§431:26-102 Applicability and scope. (a) Except as otherwise provided in this section, this article applies to all health carriers that offer fully insured network plans. (b) The following shall not apply to health carriers that offer network plans that consist solely of limited scope dental plans or limited scope vision plans: (1) Section 431:26-103(a)(2); (2) Section 431:26-103(f)(7)(E) and (f)(8)(B); (3) Paragraphs (1) and (3) of the definition of 'active course of treatment' under section 431:26-101; (4) Section 431:26-104(l)(6)(D); (5) Section 431:26-105(a)(3)(B) and (C); and (6) Section 431:26-105(a)(4)(A)(i) and (ii) and (a)(4)(B). (c) This article shall not apply to limited benefit health insurance, as provided in section 431:10A-607, except as to limited scope dental plans or limited scope vision plans as specified in subsection (b). (d) Notwithstanding any other provision in this article to the contrary, health benefit plans contracted with the department of human services med-QUEST division to provide services for medicaid beneficiaries shall continue to be subject to the network provider adequacy standards and oversight of the federal medicaid program; provided that med-QUEST division to provide services for medicaid beneficiaries shall continue to be subject to the network provider adequacy standards and oversight of the federal medicaid program; provided that the department of human services and the commissioner may collaborate to align such standards wherever possible. Nothing in this article is intended to change, delegate, or diminish the sole responsibility to monitor and regulate the medicaid managed care plans from the single state medicaid agency. [L 2017, c 191, pt of §1; am L 2019, c 70, §33]
Hawaii Legal Code