Health policy bills progressing in Hawaii

With the second lateral deadline this Friday, here is an update on some of the health policy bills we’ve been tracking in the 2018 session.

Medical Aid in Dying

The Medical Aid in Dying bill, HB 2739, continues to move through the legislature. The bill passed out of the House 39-12 earlier in March and has already passed out of the Senate Commerce, Consumer Protection and Health Committee with six yes votes and one excused. The bill remains in the Senate Judiciary Committee.

Prescription Drugs

SB 3104, which would create requirements for Pharmacy Benefits Managers and maximum allowable costs, passed out of the Senate unanimously. If passed, the bill would:

  1. Establish requirements for pharmacy benefit managers and maximum allowable cost, including the ability of pharmacies to receive comprehensive maximum allowable cost lists and bring complaints, within the purview of the department of commerce and consumer affairs, rather than the department of health;
  2. Require pharmacy benefit managers to disclose where an equivalent drug can be obtained at or below the maximum allowable cost when a maximum allowable cost is upheld on appeal;
  3. Allow contracting pharmacies to reverse and rebill claims if the pharmacy benefit manager establishes a maximum allowable cost that is denied on appeal; provided that the pharmacy benefit manager shall pay the difference to the contracting pharmacies;
  4. Clarify the available penalties for violations of maximum allowable cost requirements; and
  5. Delete a requirement that prohibits a contracting pharmacy from disclosing the maximum allowable cost list and related information to any third party.

A recent study showed that patients overpay for prescriptions, allowing PBM or insurance companies to clawback the overpayment, about 23 percent of the time.

The bill was referred to the House Committees on Health and Human Services, Consumer Protection and Commerce and Finance. It has passed out of the Health and Human Services Committee and is scheduled to be heard today in the Consumer Protection and Commerce Committee.

ACA Protections

In response to the repeal of the individual mandate, Hawaii may impose its own with SB 2924. The bill would re-establish the individual mandate with a currently unspecified tax penalty. The bill passed out of the Senate 24-1 with Senator Riviere the sole dissenting vote.

Another ACA protection bill that has quickly moved through the legislature is SB 2340. The bill would

  • Allow adult children to be covered by their parents’ insurance until the age of 26
  • Require plans to cover pre-existing health conditions
  • Prohibit gender discrimination in determining premiums

The bill passed the Senate unanimously and has already moved out of the House Health and Human Services Committee.

The legislature is considering another 1332 wavier under SB 2199 to “explore the possible establishment of a state reinsurance program for the individual health insurance market.” The bill to authorize the state to submit the waiver proposal passed the Senate unanimously. It also passed of the House Committees on Health and Human Services and Consumer Protection and Commerce.

Other Bills

The counties of Kauai and Hawaii may receive new funding for the purchase and operation costs of new ambulances. Both HB 1676 and SB 2658 have passed out of their chambers of origin.

According to Rep. Ichiyama HB 687 will not be moving forward this session. The bill would have required insurance coverage for the costs of medical transportation to the mainland for qualifying patients. Instead the legislature is going to request that the auditor conduct an analysis on the transportation mandate.