Bill > SB2390

This bill mandates that starting January 1, 2027, health insurers, mutual benefit societies, health maintenance organizations (HMOs), and health plans within the state's Medicaid managed care program must provide coverage for "biomarker testing." Biomarker testing involves analyzing a patient's tissue, blood, or other biological samples for "biomarkers," which are measurable characteristics indicating normal biological processes, disease progression, or how a patient might respond to a specific treatment, including gene mutations or protein expression. This coverage is intended to aid in diagnosing, treating, managing, or monitoring diseases and conditions, or to guide treatment decisions when supported by scientific evidence, including tests approved by the U.S. Food and Drug Administration (FDA), drug labels, Medicare coverage decisions, or recognized clinical guidelines. The bill also requires insurers to have a clear process for requesting exceptions to coverage restrictions and ensures that any cost-sharing like copayments or deductibles for biomarker testing are no less favorable than for other medical services. Furthermore, it mandates that annual policyholder information includes details about this new coverage requirement and extends these provisions to the state's Medicaid managed care program.

Health and Social Services

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=SB&billnumber=2390&year=2026