summary
Introduced
01/21/2026
01/21/2026
In Committee
01/26/2026
01/26/2026
Crossed Over
Passed
Dead
Introduced Session
2026 Regular Session
Bill Summary
Requires the Department of Human Services to establish or select and contract with a third-party administrator to serve as the State Pharmacy Benefit Manager (PBM) who shall be responsible for administering all pharmacy benefits for medicaid beneficiaries enrolled with medicaid managed care organization. Requires medicaid managed care organizations to contract with and utilize the State PBM. Establishes requirements to procure the State PBM in addition to the requirements under state law governing purchases of health and human services. Establishes requirements and prohibitions for the contract to be used by the DHS when contracting with the state PBM. Requires the DHS to establish a single-preferred drug list to be used by the State PBM. Requires the DHS to consult with the Med-QUEST Healthcare Advisory Committee on the development, implementation, and oversight of the State PBM program. Requires reports to the Legislature. Appropriates funds.
AI Summary
This bill requires the Department of Human Services (DHS) to establish or contract with a third-party administrator to act as the State Pharmacy Benefit Manager (PBM), which will manage all prescription drug benefits for Medicaid beneficiaries enrolled in managed care organizations. Medicaid managed care organizations will be required to use this State PBM. The bill outlines specific requirements for procuring the State PBM and for the contract between the DHS and the State PBM, including prohibiting "spread pricing," which is when a PBM charges more to an insurer than it pays to a pharmacy for the same service. It also mandates the DHS to create a single preferred drug list for the State PBM and to consult with the Med-QUEST Healthcare Advisory Committee on the program's development and oversight, with reports to be made to the Legislature and funds appropriated for its implementation.
Committee Categories
Health and Social Services
Sponsors (4)
Last Action
Referred to HHS/CPN, WAM/JDC. (on 01/26/2026)
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=SB&billnumber=2208&year=2026 |
| BillText | https://www.capitol.hawaii.gov/sessions/session2026/bills/SB2208_.HTM |
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