HRS §432:1-625
Who gets paid for covered health services
This section says that health care providers who do covered services must be paid, either directly or through the insured person. A provider can get paid only if the insurance plan allows it and the provider is working within their license. It also defines what a health care provider means.
The statute, as written — Reimbursement to providers
(a) Coverage for services required by this part shall include reimbursement to health care providers who perform services required by this article, or to the insured member, as appropriate. (b) Whenever an individual or group policy, contract, plan, or agreement that provides health care coverage under this article provides for reimbursement for any service, a health care provider who performs a service shall be eligible for reimbursement for the performed service to the extent the health care provider is eligible for such reimbursement under the policy, contract, plan, or agreement, and is acting within the scope of the provider's license or certification under state law. (c) For purposes of this section, "health care provider" has the same meaning as in section 431:10A–144(c).
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