Bill > HB1971

This bill mandates that starting January 1, 2027, various health insurance providers in Hawaii, including individual and group accident and health insurance policies, mutual benefit societies, health maintenance organizations (HMOs), and the state's Medicaid managed care program, must cover "biomarker testing." Biomarker testing involves analyzing a patient's biological samples (like tissue or blood) to identify specific characteristics, known as "biomarkers," which can indicate normal biological processes, diseases, or how a patient might respond to certain treatments. This coverage is intended to help diagnose, treat, manage, or monitor diseases and guide treatment decisions when supported by scientific evidence, including tests approved by the U.S. Food and Drug Administration (FDA), national or local coverage decisions from Medicare, or established clinical practice guidelines. The bill also requires insurers to have clear processes 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 covered medical services. Additionally, it mandates that annual policyholder information includes details about this new coverage requirement.

Health and Social Services

https://www.capitol.hawaii.gov/session/measure_indiv.aspx?billtype=HB&billnumber=1971&year=2026