HB 1092 Hawaii House · 2025 Regular Session

RELATING TO MEDICAID THIRD PARTY LIABILITY.

Summary

Amends third party liability provisions for Medicaid program claims for payment as required under the federal Consolidated Appropriations Act, 2022. Effective 7/1/3000. (HD1)

Bill status in committee 1 of 4 stages cleared

Introduction

Jan 2025

Committee Review

Floor Vote

Governor

Introduced Jan 21, 2025 Last action Feb 12, 2025

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What changed between versions

HB1092 → HB1092_HD1 · 4 edits

MODERATE

This bill updates Hawaii's Medicaid third-party liability laws to comply with federal requirements from the Consolidated Appropriations Act, 2022. It ensures health insurers cannot deny payment for Medicaid services based on missing prior authorization and requires faster responses to state inquiries about health claims.

Scope change

The bill maintains the same scope of applying to health insurers and third-party payers for Medicaid claims, but adds specific conditions under which insurers must accept state claims regardless of prior authorization status.

REQUIREMENT

Health insurers must respond to state inquiries about health care claims within 60 calendar days, matching the federal requirement.

Insurers cannot deny claims solely because of submission date, claim form type, lack of point-of-sale documentation, or missing prior authorization when the claim is submitted within three years of service and enforcement action is started within six years.

TIMELINE

The bill's effective date was changed from 'upon approval' to July 1, 3000, which appears to be a placeholder or clerical error rather than a substantive policy change.

TECHNICAL

Formatting and markup changes were made to convert the bill from a draft version to a House of Representatives version with updated metadata and headers.

Floor votes

How they voted

No floor votes recorded yet.

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Feb 12, 2025

Committee

Reported from HLT (Stand. Com. Rep. No. 446) as amended in HD 1, recommending passage on Second Reading and referral to CPC.

lower

Feb 7, 2025

Lower · Passed

The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 9 Ayes: Representative(s) Takayama, Keohokapu-Lee Loy, Amato, Chun, Marten, Olds, Takenouchi, Alcos, Garcia; Ayes with reservations: none; 0 Noes: none; and 0 Excused: none.

lower

Jan 23, 2025

Committee

Referred to HLT, CPC, referral sheet 3

lower

Jan 23, 2025

Introduced

Introduced and Pass First Reading.

lower

Jan 21, 2025

Introduced

Pending introduction.

lower

1 primary · 0 co-sponsors