§432E-3 - Access to services. - Hawaii Statutes

     §432E-3  Access to services.  A managed care plan shall demonstrate to the commissioner upon request that its plan:

     (1)  Makes benefits available and accessible to each enrollee electing the managed care plan in the defined service area with reasonable promptness and in a manner which promotes continuity in the provision of health care services;

     (2)  Provides access to sufficient numbers and types of providers to ensure that all covered services will be accessible without unreasonable delay;

     (3)  When medically necessary, provides health care services twenty-four hours a day, seven days a week;

     (4)  Provides a reasonable choice of qualified providers of women's health services such as gynecologists, obstetricians, certified nurse-midwives, and advanced practice nurses to provide preventive and routine women's health care services;

     (5)  Provides payment or reimbursement for adequately documented emergency services as provided in this chapter; and

     (6)  Allows standing referrals to specialists capable of providing and coordinating primary and specialty care for an enrollee's life-threatening, chronic, degenerative, or disabling disease or condition. [L 1998, c 178, pt of §2; am L 1999, c 137, §4]