THE SENATE

S.B. NO.

2009

THIRTIETH LEGISLATURE, 2020

S.D. 1

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


SECTION 1. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to part I of article 10A to be appropriately designated and to read as follows:

"431:10A-A Cost-sharing in prescription insulin drugs; limits. (a) Each policy of accident and health or sickness insurance providing coverage for prescription insulin drugs shall cap the total amount that a policyholder or individual covered under the policy is required to pay for an in-network purchase of a prescription insulin drug covered under the policy's formulary at an amount not to exceed $100 per thirty-day supply of that drug, regardless of the amount or type of insulin needed to fill the covered person's prescription.

(b) Nothing in this section shall prevent an insurer from reducing a policyholder's cost-sharing by an amount greater than the amount specified in subsection (a).

(c) As used in this section, unless the context clearly requires otherwise, "prescription insulin drug" means a prescription drug, as defined in section 328-1, that contains insulin and is used to treat diabetes."

SECTION 2. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to part II of article 10A to be appropriately designated and to read as follows:

"431:10A-B Cost-sharing in prescription insulin drugs; limits. (a) Each group policy of accident and health or sickness insurance providing coverage for prescription insulin drugs shall cap the total amount that a policyholder is required to pay for an in-network purchase of a prescription insulin drug covered under the policy's formulary at an amount not to exceed $100 per thirty-day supply of that drug, regardless of the amount or type of insulin needed to fill the insured's prescription.

(b) Nothing in this section shall prevent an insurer from reducing a policyholder's cost-sharing by an amount greater than the amount specified in subsection (a).

(c) As used in this section, unless the context clearly requires otherwise, "prescription insulin drug" means a prescription drug, as defined in section 328-1, that contains insulin and is used to treat diabetes."

SECTION 3. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to part VI of article 1 to be appropriately designated and to read as follows:

"432:1-   Cost-sharing in prescription insulin drugs; limits. (a) Each individual and group hospital and medical service plan contract providing coverage for prescription insulin drugs shall cap the total amount that a subscriber is required to pay for an in-network purchase of a prescription insulin drug covered under the plan contract's formulary at an amount not to exceed $100 per thirty-day supply of that drug, regardless of the amount or type of insulin needed to fill the subscriber's prescription.

(b) Nothing in this section shall prevent a mutual benefit society from reducing a subscriber's cost-sharing by an amount greater than the amount specified in subsection (a).

(c) As used in this section, unless the context clearly requires otherwise, "prescription insulin drug" means a prescription drug, as defined in section 328-1, that contains insulin and is used to treat diabetes."

SECTION 4. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:

"432D-23 Required provisions and benefits. Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-140, 431:10A-A, and 431:10A-134, and chapter 431M."

SECTION 5. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

SECTION 6. In codifying the new sections added by sections 1 and 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

SECTION 7. Section 23-51, Hawaii Revised Statutes, shall not apply to this Act as the amendments herein are a clarification of an existing medical insurance benefit.

SECTION 8. New statutory material is underscored.

SECTION 9. This Act shall take effect on July 1, 2050.


 


 

Report Title:

Insurance; Insulin; Cost-sharing; Caps

 

Description:

Places a cap on the total amount that an insured is required to pay for an in-network purchase of a prescription insulin drug covered under a health benefit plan's formulary at $100 per thirty-day supply of that drug. Clarifies existing drug benefit and therefore is exempt from the impact assessment report. Effective 7/1/2050. (SD1)

 

 

 

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