Relating To Health Care Insurance.
If enacted, SB218 will amend existing provisions within various sections of the Hawaii Revised Statutes concerning health care insurance. The bill specifically mandates that no individual or group health insurance policy will require a patient diagnosed with intermediate to advanced stages of cancer to undergo any step therapy process before receiving prescribed drugs. It outlines conditions under which prescribed medications must be covered, including those approved by the FDA or recognized in peer-reviewed studies. Moreover, the legislation includes a requirement for an auditor to conduct an impact assessment report evaluating the social and financial ramifications of this mandated coverage.
Senate Bill 218, introduced in the State of Hawaii, addresses the significant issue of step therapy in the context of health insurance for patients diagnosed with stage two to stage four cancer. This legislation aims to prohibit health insurers from mandating step therapy protocols that require patients to try certain medications before they are allowed to receive the treatment prescribed by their healthcare provider. Recognizing cancer as the second leading cause of death in Hawaii, the bill emphasizes the urgency for timely and effective treatment for cancer patients, who often face delays due to such protocols.
While supporters of SB218 advocate for patient-centered approaches that prioritize immediate access to effective treatments, there may be concerns regarding the potential financial implications for health insurers and the overall healthcare system. Possible contention points include debates over cost management versus patient outcomes, as insurers may argue that step therapy protocols can help control drug costs and ensure the most effective treatments are utilized first. However, proponents stress that delaying treatment through step therapy can lead to worsened health outcomes and increased long-term costs for the healthcare system.