TWENTY-FIFTH LEGISLATURE, 2010
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO INSURANCE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Section 87A-16, Hawaii Revised Statutes, is amended to read as follows:
Health benefits plan; carriers. (a) The board shall establish the health
benefits plan or plans, which shall be exempt from the minimum group
requirements of chapter 431.
(b) The board may contract for health benefits plans or provide health benefits through a noninsured schedule of benefits.
(c) Notwithstanding any law to the contrary, the board
shall, during open enrollment and other enrollment periods, offer an
employee-beneficiary or dependent-beneficiary eligible for enrollment and
currently enrolled in a health benefits plan established under this section,
coverage for prescription drug benefits that is identical to the coverage
provided under the employee-beneficiary's or dependent-beneficiary's current
For the purposes of this subsection:
"Coverage" means the benefits, costs, and requirements for patient access to medical products and services as enumerated in the written explanation of benefits document issued by the board or pharmacy benefits manager.
"Identical" means the exact benefit as provided in the written explanation of benefits document issued by the board or pharmacy benefits manager.
"Prescription drug benefits" means the prescription drug benefits as defined in the explanation of benefits document issued by the board or pharmacy benefits manager that describes the cost, cost-sharing, and available medications, as well as any utilization management requirements that patients must meet to access the prescribed drug."
SECTION 2. The purpose of this part is to improve access to the full range of health care services to Medicaid and QUEST members, by ensuring that Medicaid and QUEST health plans have the flexibility to provide appropriate health services via technological means such as telehealth.
SECTION 3. Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:
"§346- Telehealth services; Medicaid and QUEST. The department shall not require:
(1) The department's approval for a health plan under the department's Medicaid or QUEST program to deliver services using a telehealth service; or
(2) In-person visits to qualify any telehealth service for coverage under the department's Medicaid or QUEST program.
For the purposes of this section, "telehealth" means the use of telecommunications services, as defined in section 269-1, including real-time video conferencing-based communication, secure interactive and non-interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information to parties separated by distance. A standard telephone contact, facsimile transmission, or an email text, in combination or by itself, does not constitute a telehealth service for the purposes of this section."
SECTION 4. Part II of this Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.
SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 6. This Act shall take effect on July 1, 2020; provided that the provisions of section 87A-16(c), Hawaii Revised Statutes, in section 1 of this Act shall retroactively apply to prescription drug plans of employee-beneficiaries and dependent-beneficiaries of the employer-union health benefits trust fund enrolled in health plans as of the effective date of this Act, who enrolled during the open enrollment periods ending on:
(1) For active employees, December 7, 2009; and
(2) For retirees, November 30, 2009;
provided further that notwithstanding the close of these open enrollment periods, these beneficiaries shall prior to , be offered the coverage for prescription drug benefits required under section 87A-16(c), Hawaii Revised Statutes, in section 1 of this Act.
Health Insurance; Drug Coverage; EUTF; Telehealth; Medicaid; QUEST
Requires EUTF health benefits plans to allow enrollees to continue the same prescription drug coverage for current enrollees, and applies this provision retroactively to the 2009 EUTF open enrollment period. Prohibits the Department of Human Services from requiring its approval for a Medicaid or QUEST health plan to deliver services through telehealth, and from requiring in-person health care visits to qualify telehealth services for coverage under these health plans.
Effective July 1, 2020. (SB2494 HD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.