The director of health shall adopt rules in accordance with chapter 91 which are necessary to carry out this chapter. The rules shall include, but need not be limited to:

(1) Establishment of guidelines for the purchase of health care coverage from health care contractors by the department;

Terms Used In Hawaii Revised Statutes 431N-5

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Gap group individuals: means medically uninsured persons who are residents of the State. See Hawaii Revised Statutes 431N-2
  • Health care coverage: means contractually arranged medical, personal, or other services, including preventive services, education, case management, and outreach, provided to an eligible member. See Hawaii Revised Statutes 431N-2
(2) Establishment of specific health care services to be covered, limited, and excluded by the program, including preventive services, outreach, and education strategies designed to reach gap group individuals;
(3) Establishment of eligibility requirements for participation in the program;
(4) Development and implementation of an identification and notification process for eligible program participants;
(5) Establishment of a payment schedule based on the person’s ability to pay;
(6) Establishment of program participation criteria for health care contractors;
(7) Establishment of monitoring and evaluative guidelines for the program;
(8) Establishment of appeal procedures for denial of eligibility, disqualification from program participation, assessment of civil penalties, or other negative action; and
(9) Establishment of procedures to exclude or remove from the program persons who drop individual or group coverage to obtain insurance.

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