AI Frontier Institute

Relating To The Hawaii Patients' Bill Of Rights And Responsibilities Act.

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Hawaii S.B. 2167 (33rd Legislature, 2026) modernizes the Hawaii Patients' Bill of Rights and Responsibilities Act (Chapter 432E, Hawaii Revised Statutes) to address AI-driven claim denials, telehealth access, data privacy, and enforcement. Section 2 adds a new part to Chapter 432E establishing definitions for 'automated decision system,' 'prior authorization,' and 'telehealth services,' and requires: telehealth coverage at parity with in-person services in health professional shortage areas; prior authorization decisions within one business day for urgent requests and three business days for non-urgent requests; board-certified specialist co-signature on any denial initiated by an automated decision system; written notice to enrollees and providers when an automated decision system is used; and quarterly and monthly reporting by health carriers to the insurance commissioner on provider ratios, wait times, and denial rates. Section 3 adds four new sections to Part II of Chapter 432E: Section 432E-A prohibits managed care plans from denying emergency services based on retrospective review; Section 432E-B (effective January 1, 2027) requires covered entities to meet or exceed HIPAA data protection standards (45 C.F.R. Parts 160 and 164), file attestations before offshoring enrollee data, notify enrollees and the commissioner within 72 hours of a data breach, and face fines or revocation of accreditation for repeated violations; Section 432E-C establishes a multidisciplinary advisory group within the Department of Health to review compliance and emerging issues; and Section 432E-D prohibits retaliation against providers who file complaints or participate in external reviews. Sections 4 through 8 amend existing sections 432E-4, 432E-5, 432E-7, 432E-8, and 432E-13 to strengthen enrollee participation in treatment decisions, expand appeals procedures (including a 72-hour expedited appeal timeline and 130-day external review deadline), require publicly accessible provider directories updated at least quarterly with telehealth availability, expand the commissioner's authority to audit, investigate, impose fines, clawbacks, and revoke accreditation, and mandate annual legislative reports covering automated decision system usage, denial statistics, and data breaches. Section 9 requires the insurance commissioner to submit a progress report to the legislature no later than 20 days before the 2028 regular session.

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