Relating To Title 24, Hawaii Revised Statutes.
If enacted, HB1028 would have a significant effect on how health insurance policies manage external reviews regarding medically necessary services. This aligns state law with national standards, potentially leading to better access to vital health services like mammograms without the burden of excessive restrictions that could delay care. The bill aims to protect patients' rights and improve health outcomes by ensuring that necessary medical services are accessible and that insurers comply with the specified coverage obligations.
House Bill 1028 aims to amend specific provisions in Title 24 of the Hawaii Revised Statutes concerning accident and health insurance policies. The bill proposes amendments to the external review procedures, enhancing consistency with the National Association of Insurance Commissioners Uniform Health Carrier External Review Model Act. One significant aspect of the bill is the requirement for health insurers, mutual benefit societies, and health maintenance organizations to provide coverage for mandated services related to mammography at least as favorably as they would cover other radiological examinations. This includes annual mammograms for women aged 40 and above as well as coverage for women with a history of breast cancer.
While proponents of HB1028 advocate for enhanced patient protections, opponents may raise concerns about the implications of the mandated coverage on insurance costs and overall healthcare premiums. The debate may center around balancing improved access to healthcare with the financial impact on insurers and policyholders. Furthermore, some stakeholders may question whether such mandates might lead to increased costs ultimately passed on to consumers, complicating the overall viability of health insurance products in the state.