Hawaii Medicaid, administered by the Department of Human Services' Med-QUEST Division, is delivered almost entirely through a single Section 1115 demonstration, QUEST Integration, one of the oldest continuously operating state 1115 demonstrations in the country, currently extended through December 31, 2029. Five managed care plans cover the state: AlohaCare, HMSA, Kaiser Permanente, 'Ohana Health Plan, and UnitedHealthcare Community Plan. Long-term services and supports are fully folded into this same demonstration rather than run under a separate waiver or carve-out; the one exception is a narrow population served by a single Section 1915(c) HCBS waiver for intellectual and developmental disabilities, administered not by Med-QUEST but by the Department of Health's Developmental Disabilities Division. Community Care Services (CCS), Hawaii's behavioral health carve-out for its highest-need population, is a separately-procured program currently mid-re-procurement. Conduent State Healthcare LLC serves as Hawaii's Medicaid fiscal agent and combined pharmacy benefit manager; Client Network Services, LLC (CNSI) is a separate, independently-contracted vendor operating the state's own HOKU provider enrollment and management system.
Five health plans currently serve QUEST Integration members statewide: AlohaCare, HMSA, Kaiser Permanente, 'Ohana Health Plan, and UnitedHealthcare Community Plan. 'Ohana Health Plan is a WellCare-branded plan (Centene).
Long-term services and supports are integrated into QUEST Integration's own five managed care plans for the general population; there is no separate statewide LTSS waiver or MLTSS carve-out sitting alongside the 1115 demonstration the way several other states run one. The one narrow exception is the HCB Services for People with Intellectual and Developmental Disabilities (I/DD) Waiver, a currently active Section 1915(c) waiver (CMS number 0013.R09.00, effective through June 30, 2031) providing adult day health, discovery and career planning, individual employment supports, and personal assistance/habilitation to individuals with intellectual or developmental disabilities who meet an ICF/IID level of care. This waiver is administered by the Department of Health's Developmental Disabilities Division rather than by Med-QUEST. No 1915(b) managed care waiver exists for Hawaii at all, consistent with QUEST Integration's own five MCOs already operating directly under the 1115 demonstration rather than a separate managed-care authority.
Integrated into managed care
Community Care Services (CCS) is Hawaii's distinct, separately-procured behavioral health carve-out for its highest-need population, a different program from QUEST Integration's own general-population coverage, not folded into it. CCS is currently operated by 'Ohana Health Plan and is in the middle of a re-procurement that could result in a new vendor.
Carved out
Dental services have their own dedicated chapter (Chapter 14) in Med-QUEST's consolidated Medicaid Provider Manual. No dental-specific administrator or vendor is named, and whether dental runs as a full fee-for-service carve-out, an MCO-integrated benefit, or a mix of the two is unclear.
Conduent State Healthcare LLC is Hawaii's combined Fiscal Agent and Pharmacy Benefit Manager, administering both functions under one contract. FFS drug coverage and reimbursement questions are directed to Conduent directly. No separate PBM subcontractor is named for Hawaii's pharmacy program.
Conduent State Healthcare LLC operates Hawaii's Medicaid Management Information System as fiscal agent. Client Network Services, LLC (CNSI) is a separate vendor operating HOKU, the state's web-based provider enrollment system (hoku.hawaii.gov).
Last updated: Aug 29, 2026
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