HRS §431:14G-112
How to appeal a health plan decision
If a managed care plan disagrees with a decision made by the insurance commissioner without a hearing, it can ask for a hearing within 30 days. The commissioner must hold the hearing within 20 days and decide within 15 days after it ends. The plan can also appeal the final decision to court.
The statute, as written — Hearing procedure and judicial review
(a) Any managed care plan aggrieved by any order or decision of the commissioner made without a hearing, within thirty days after notice of the order to the managed care plan, may make written request to the commissioner for a hearing. The commissioner shall hold a hearing within twenty days after receipt of the request, and shall give not less than ten days' written notice of the time and place of the hearing. The commissioner shall promptly conduct and complete the hearing. Within fifteen days after the hearing is completed, the commissioner shall affirm, reverse, or modify the commissioner's previous action, specifying the reasons for the commissioner's decision. Pending the hearing and decision, the commissioner may suspend or postpone the effective date of the commissioner's previous action. (b) Any final order or decision of the commissioner may be reviewed in the circuit court of the first circuit and an appeal from the decision of the court shall lie to the supreme court. The review shall be taken and had in the manner provided in chapter 91.
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