Bill > SB969

This bill requires health insurance providers in Hawaii, including individual and group policies, hospital and medical service plans, and Medicaid managed care programs, to provide coverage for biomarker testing beginning January 1, 2026. Biomarker testing is defined as the analysis of a patient's tissue, blood, or other biospecimen to identify characteristics that indicate normal or pathogenic biological processes, or potential responses to medical interventions. The coverage must support diagnosis, treatment, disease management, and treatment decision-making, and be based on various authoritative sources such as FDA-approved tests and indications, national medical coverage determinations, and recognized clinical practice guidelines. The bill mandates that insurers provide this coverage with terms no less favorable than other medical services, limit disruptions in patient care, offer a clear process for requesting exceptions to coverage restrictions, and notify policyholders about the new benefit by the end of 2026. The legislation aims to ensure patients have access to advanced diagnostic and personalized medical testing that can help improve treatment outcomes across various medical conditions.

Health and Social Services

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=SB&billnumber=969&year=2025