AI Frontier Institute

Relating To The Patients' Bill Of Rights.

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Hawaii S.B. 3027 (33rd Legislature, 2026), titled the 'Hawaii Patients' Bill of Rights of 2025,' amends Chapter 432E of the Hawaii Revised Statutes by adding six new sections and updating existing provisions. Section 3 adds new sections requiring: (1) enrollee rights to timely specialist access and telehealth parity reimbursement; (2) prior authorization timelines—one business day for urgent services and three business days for non-urgent services—plus written adverse-determination notices citing appeal rights under sections 432E-5 and 432E-33, monthly carrier reporting to the insurance commissioner, and commissioner reports to the legislature beginning 20 days before the 2028 session; (3) automated decision support tool (AI) oversight requiring written disclosure in every plan, independent board-certified clinician review before any AI-contributed adverse action is issued, and governance/bias-testing documentation available for annual commissioner review by June 30, 2027; (4) data protection requirements meeting or exceeding HIPAA (P.L. 104-191, 45 CFR parts 160 and 164), offshoring contract attestations to the commissioner by June 30, 2027, and 72-hour breach notification to the commissioner and all enrollees; (5) quarterly network adequacy reports to the commissioner covering provider ratios, wait times, telehealth utilization, and referral outcomes; and (6) anti-retaliation protections for providers and technical assistance from the insurance commissioner and the Department of Commerce and Consumer Affairs for small and rural practices. Section 4 adds definitions including 'artificial intelligence,' 'automated decision support tool,' 'offshoring contract,' 'prior authorization,' and 'urgent health care service.' Section 5 amends section 432E-1.4 to prohibit retroactive denial of medically necessary emergency services. Section 6 amends section 432E-7 to require quarterly (rather than regular) provider list updates and a step-by-step appeals/external-review explanation. Section 7 amends section 432E-8 to expand the insurance commissioner's enforcement authority to include audits, restitution orders, accreditation revocation, and injunctive relief, plus an annual public enforcement report. The Act takes effect July 1, 2026 per Section 10.

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