Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1735.2 - GENERAL PROVISIONS FOR PARTICIPATING HEALTH PLANS
Section 17-1735.2-7 - Termination of contract with participating health plan
Universal Citation: HI Admin Rules 17-1735.2-7
Current through November, 2024
(a) The department shall have the authority to terminate the participating health plan's contract for any or all of the following reasons:
(1) Convenience;
(2) Default by the health plan;
(3) Expiration of the medical assistance
program;
(4) Failure by the health
plan to abide by the contract conditions;
(5) Insolvency of or declaration of
bankruptcy by the health plan;
(6)
Failure to meet federal or state statutes, or both; or
(7) Unavailability of funds.
(b) When termination of contract is due to reasons identified under subsections (a)(2), (4) or (6), the department shall provide a hearing for the affected health plan prior to termination of the contract.
(c) After the department notifies the health plan of its intent to terminate the contract due to reasons identified under subsections (a)(2), (4) or (6), the department may do the following:
(1) Provide
the affected eligible individual written notice of the department's intent to
terminate the contract; and
(2)
Allow the affected eligible individual to change health plans immediately
without cause.
Disclaimer: These regulations may not be the most recent version. Hawaii may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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