Credentialing in Hawaii

Hawaii Medicaid is run by the DHS Med-QUEST Division (MQD). 'New providers are required to enroll as a Medicaid provider using HOKU' (account creation at hoku.hawaii.gov/UserRegistration); MQD also accepts new provider applications or change requests by email, fax, or mail on form DHS 1139 (Rev 11/2022). State enrollment is the foundation, each QUEST Integration plan then credentials/contracts separately.

Med-QUEST 'Be a New Provider' page via kb/states/hi.md · checked Jul 2026

Hawaii is an (almost) all-MCO state: 'QUEST Integration uses capitated managed care as a delivery system unless otherwise indicated', an 1115 demonstration running since August 1, 1994 (QUEST and QExA merged into QUEST Integration in January 2015, with long-term services and supports inside the plans). Providers contract per-plan on top of Med-QUEST enrollment.

Med-QUEST QUEST Integration page via kb/states/hi.md · checked Jul 2026

Hawaii's associate behavioral-health licenses are brand-new: Act 93 (SLH 2024) created the Associate Mental Health Counselor (AMHC) and Associate Marriage and Family Therapist (AMFT), plus associate psychologists, implemented July 1, 2026, with applications open since June 1, 2026. As of the vault's verification, no Med-QUEST, QI-plan, or CCS rule recognizing the new associates as billable rendering providers had been sourced, so associate Medicaid billability remains unestablished. Social work has no associate tier (LBSW/LSW/LCSW only).

Hawaii DCCA release 2026-06-19, 'DCCA expands pathway for mental health professionals' via kb/states/hi.md · checked Jul 2026

Counselor, MFT, and social-work licensing sit under Hawaii DCCA Professional & Vocational Licensing as director-administered programs (Mental Health Counselor, Marriage and Family Therapist, Social Worker) rather than autonomous boards; Psychology is a board. Since July 1, 2026 the counselor and MFT programs also issue the new AMHC/AMFT associate licenses.

Hawaii DCCA Professional & Vocational Licensing boards list via kb/states/hi.md · checked Jul 2026

Hawaii is NOT on the Counseling Compact jurisdictions list. Mainland LPCs cannot practice into Hawaii on a compact privilege and need full Hawaii licensure.

Counseling Compact jurisdictions list via kb/states/hi.md · checked Jul 2026

Standard outpatient behavioral health is covered through the member's QUEST Integration plan, but 'Adult Medicaid members age 18 years or older with a diagnosis of serious mental illness (SMI) or a severe and persistent mental illness (SPMI) may be eligible for additional behavioral health services from the Community Care Services (CCS) program offered by 'Ohana Health Plan.' CCS is a separate statewide managed behavioral-health plan operated by 'Ohana (a WellCare subsidiary) under Med-QUEST contract, serving all islands, a behavioral-health practice targeting the SMI population needs CCS credentialing with 'Ohana on top of QI-plan panels.

'Ohana Health Plan Community Care Services provider page via kb/states/hi.md · checked Jul 2026

'Currently, all dental services are provided under the fee-for-service program'. Dental is Hawaii's notable carve-out from QUEST Integration managed care, so dental providers bill the state fee-for-service rather than the QI plans.

Med-QUEST 'Be a New Provider' page via kb/states/hi.md · checked Jul 2026

The five QUEST Integration plans are AlohaCare, HMSA, Kaiser Permanente, 'Ohana Health Plan (WellCare), and UnitedHealthcare Community Plan. A provider who wants managed-care revenue needs separate credentialing/contracting with each plan they intend to bill.

Med-QUEST Health Plans page via kb/states/hi.md · checked Jul 2026