HI · last verified 2026-05-12
Hawaii — NSA dispute pathway
Ground-ambulance balance-billing law
NO STATE LAW
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State IDR pathway
[VERIFY PENDING]
Federal IDR (45 CFR §149.510)
ERISA self-funded plans
STATE DOI HAS NO JURISDICTION
Self-funded plans always route to Federal IDR + DOL/EBSA enforcement, regardless of state.
How Hawaii fits the NSA picture
Hawaii LRB 2024 acts compilation reviewed; no enacted state law on ground-ambulance balance billing. Claims attributing protection to 'Hawaii Act 189' appear to be misattribution — Act 189/2024 covers reporting periods, not ambulances.
Free first step — CMS No Surprises Help Desk
The CMS-administered consumer complaint pathway. Free, federal, and the recommended first action for any balance-billed insured patient. You have 90 calendar days from when you knew or should have known of the NSA violation to file.