Under the provisions of the HMSA Participating Optometrist Medical Plan Agreement (Section VII), HMSA may terminate a provider's agreement if the provider does not comply with the agreement provisions. In these cases, HMSA may terminate a provider's contract with cause by providing 60 days' written notice.
If the provider's license to practice in the state of Hawaii has expired or been revoked, suspended, limited or conditioned, HMSA may terminate the agreement immediately upon written notice to the provider.
Appealing a Termination
If a provider decides to appeal the termination of his or her HMSA Participating Optometrist Medical Plan Agreement, the appeal must be made in writing within 60 days of the optometrist's receipt of HMSA's written termination notice.
HMSA will convene a review committee within 30 days of receiving the provider's written request for an appeal. The provider may appear to present evidence of testimony before the committee.
The committee will either uphold or reverse the termination decision and notify the provider of its determination within five working days. If the committee determines to uphold the termination decision, the letter will give the provider information about the arbitration process. Arbitration is the final avenue of appeal.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |