Hawaii
LLC
Website link to register:
https://cca.hawaii.gov/breg
Naming conventions
Must not imply a government agency or illegal purpose. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLCs must include “Professional Limited Liability Company.”
Licensing Requirements
Medical licenses for all members must be verified by the Hawaii Professional & Vocational Licensing Division. Malpractice insurance is mandatory. Comply with local zoning laws for medical facilities.
Required documentation for medical practices
Articles of Organization, Zoning Compliance Certificates, Professional Licenses, Malpractice Insurance
Filing Fee: $51
Annual/Biennial Fee: $15
Additional Notes: Annual report due end of anniversary quarter.
Medicaid
Program Name: Med-QUEST
Official Website: http://medquest.hawaii.gov/
Legislation:No specific DPC legislation; practices operate under general healthcare and insurance laws.
Private Contracting
Permitted; DPC practices should ensure compliance with state insurance regulations to avoid being classified as insurers.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is necessary.
Medicaid Program
Hawaii Medicaid, known as Med-QUEST, provides health coverage to eligible low-income residents, including children.
Notification Requirements
Notification recommended but not mandatory.
Provider Enrollment Requirements
Providers must enroll with Med-QUEST to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot serve as Medicaid PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless clear documentation exists.
CMS Guidance
CMS provides guidance on streamlined enrollments.
Opportunities for Collaboration
Potential collaboration with Medicaid Managed Care Organizations (MCOs) or participation in state healthcare initiatives.
State-Specific Notes
Collaboration opportunities with Med-QUEST plans to enhance primary care delivery.
Dispensing Medication
Board of Pharmacy Official Link: https://cca.hawaii.gov/pvl/boards/pharmacy/
State Licensing
Physicians must register with the Hawaii Board of Pharmacy for controlled substances and adhere to state dispensing regulations.
Scope of Practice
Physicians may dispense medications within their scope of practice, including controlled substances with proper licensing.
Inventory Management
Inventory management must ensure secure storage and accurate logs for controlled substances.
Record-Keeping
Detailed records must meet state and federal regulations and be available for inspection.
Dispensing Standards
Labels must comply with Hawaii state laws, including patient details, medication name, dosage, and usage instructions.
Controlled Substances
Controlled substances require DEA registration and reporting to Hawaii’s PDMP.
Billing and Reimbursement
Billing practices must comply with state and federal regulations, including anti-kickback laws.
Federal Compliance
Physicians must adhere to federal compliance, including FDA and DEA regulations.
State Pharmacy Laws
Hawaii Board of Pharmacy requires compliance with state laws for dispensing controlled substances.
Patient Consent
Informed patient consent is mandatory prior to dispensing any medication.
Insurance and Liability
Physicians must ensure malpractice insurance covers medication dispensing risks.
Training Requirements
Continuing education is encouraged for physicians dispensing controlled substances in Hawaii.
Audits and Inspections
Regular inspections are conducted by the Hawaii Board of Pharmacy to ensure compliance, with penalties for violations.