Bill > HB553

This bill requires health insurance providers in Hawaii to cover biomarker testing starting January 1, 2026, for diagnosis, treatment, management, or monitoring of medical conditions. Biomarker testing involves analyzing a patient's tissue, blood, or other specimens to detect biological markers like gene mutations, protein expressions, or other characteristics that can indicate disease processes or potential treatment responses. The bill mandates that insurers cover biomarker tests supported by various authoritative sources, including FDA-approved test indications, drug approvals, national medical guidelines, and expert consensus statements. Insurers must provide coverage that minimizes patient care disruptions, offer a clear process for requesting exceptions to coverage limitations, and ensure that patient out-of-pocket costs for biomarker testing are no more restrictive than costs for other medical services. By January 1, 2026, insurers must notify policyholders about this new coverage requirement. The bill applies to individual and group health insurance policies, hospital and medical service plans, and health maintenance organizations, and will also extend coverage requirements to the state's Medicaid managed care program. The legislation aims to improve patient access to advanced diagnostic and personalized medical testing technologies.

Business and Industry, Health and Social Services

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=HB&billnumber=553&year=2026