Written by a parent, not a doctor. Nothing here is medical advice.

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Hawaii program

Transplant care through Hawaii’s state program (SHOTT)

Hawaii’s transplant program coordinates approved organ and tissue transplants with your child’s treatment team.

What it is

Hawaii’s transplant program coordinates approved organ and tissue transplants with your child’s treatment team.

If the oncology team discusses transplant, SHOTT is the state program that reviews and coordinates that care. Your child’s doctor starts the referral with the health plan. Travel and the treatment center need planning together.

Eligibility rules
  • Your child must have QUEST Integration or Medicaid fee-for-service coverage.
  • The under-21 list specifically names stem cell and bone marrow transplant.
What you get
  • Approved transplant care through the state program.
  • Coordination between the doctor, transplant program and the team responsible for paying for care.
What the help covers
  • The treating physician refers your child and identifies the proposed treatment and center.
  • Your transplant team and Med-QUEST confirm whether a proposed CAR-T treatment is reviewed through SHOTT, QUEST medical management or Medicaid fee-for-service. EPSDT can be relevant for a child under 21. A treatment missing from the SHOTT list is not automatically excluded from Medicaid.
If you decide to apply
  1. Ask the oncologist whether SHOTT is the route for the transplant being considered.
  2. Ask the health plan to coordinate the referral, proposed center and travel needs with the doctor.

SHOTT/Koan: 808-469-4500 or 1-844-235-5472. · Official page ↗

What happens next
  • The transplant team refers the proposed transplant for SHOTT review with Koan. Koan’s published contact is 808-469-4500 or 1-844-235-5472.
  • The QUEST contract provides for Medicaid fee-for-service after SHOTT approval. The referral team confirms the receiving center, payer transition, escort, lodging and travel approvals. Koan and Med-QUEST confirm the current center list and expected time for each step; there is no promised single timetable for the whole trip.
Good to know

A transplant referral does not settle whether a particular treatment or center is covered.

Other details
  • Mainland treatment and travel need separate approvals. The original QUEST plan may not remain responsible after the SHOTT coverage transition.
Official sources
Ask your social worker

“If transplant is being considered, could you explain what SHOTT would cover and any limits? Could you help coordinate the referral and travel review?”

Why I’m asking: I want the treatment decision and travel arrangements to fit together.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the referral the week transplant is first mentioned and keep the date.

Your social worker

The oncologist makes the referral; the health plan supports it.

The care team

The oncologist names the protocol and the centre.

Who decides
Med-QUEST through the transplant programme, with the health plan.
Ask the care team
“Can you refer us to the state transplant programme this week, and can the health plan start the travel authorisation at the same time?”

How to apply

First step: Ask the oncologist to make the transplant programme referral this week.

  1. Ask the oncologist this week to start the transplant programme referral.
  2. Ask which mainland centre, and whether travel is being booked at the same time.
  3. Ask plainly whether the plan treats CAR-T under this programme.

Official application / program page ↗

Where it starts: Ask the oncologist to refer, with the health plan. Programme contact: Koan, 808-469-4500 or 1-844-235-5472.

What to gather

  • The protocol name
  • the QUEST plan card
  • the proposed centre

How long: The team confirms clinical review, center acceptance, payer transition and travel timing separately. A seven-day QUEST decision standard does not cover the whole transplant arrangement.

What a yes looks like

A named centre, an authorisation, and travel being booked for the child and a parent.

What a no looks like, and the next move

Ask whether it was refused as a transplant or as an out-of-network procedure, and appeal on 808-692-8094.

Watch out

  • CAR-T was not confirmed as inside the programme; ask rather than assume.
  • No list of the mainland centres Hawaii uses was published.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Transplant care arranged through the state programme, with stem cell and bone marrow transplant named on the under-21 list.

Covers: Transplant authorisation and coordination for QUEST Integration and fee-for-service members · Stem cell and bone marrow transplant for a child under 21

Legal protection: The referral runs through the doctor and the health plan, not through the family

What it costs the family: No separate charge; it is Med-QUEST coverage.

The eligibility facts, as published

Coverage
QUEST Integration or Medicaid fee-for-service
Age
the under-21 list names stem cell and bone marrow transplant
Referral
by the treating physician with help from the health plan
Car t
NOT FOUND

The trap: The QUEST contract provides for Medicaid fee-for-service after SHOTT approval. The team confirms the payer transition, center and travel approvals. CAR-T requires its own medical-necessity and EPSDT review; a SHOTT listing does not settle every Medicaid benefit.

Where I read this

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