Hawaii 2024 Regular Session

Hawaii House Bill HCR225 Compare Versions

Only one version of the bill is available at this time.

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1	1	HOUSE OF REPRESENTATIVES H.C.R. NO. 225 THIRTY-SECOND LEGISLATURE, 2024 STATE OF HAWAII HOUSE CONCURRENT RESOLUTION REQUESTING THE AUDITOR TO CONDUCT A SOCIAL AND FINANCIAL ASSESSMENT OF PROPOSED MANDATORY HEALTH INSURANCE COVERAGE FOR STEP THERAPY REQUIREMENTS FOR STAGE TWO THROUGH STAGE FIVE CANCER.
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3	3	HOUSE OF REPRESENTATIVES H.C.R. NO. 225
4	4	THIRTY-SECOND LEGISLATURE, 2024
5	5	STATE OF HAWAII
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7	7	HOUSE OF REPRESENTATIVES
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9	9	H.C.R. NO.
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13	13	THIRTY-SECOND LEGISLATURE, 2024
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17	17	STATE OF HAWAII
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29	29	HOUSE CONCURRENT
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31	31	RESOLUTION
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37	37	REQUESTING THE AUDITOR TO CONDUCT A SOCIAL AND FINANCIAL ASSESSMENT OF PROPOSED MANDATORY HEALTH INSURANCE COVERAGE FOR STEP THERAPY REQUIREMENTS FOR STAGE TWO THROUGH STAGE FIVE CANCER.
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43	43	WHEREAS, cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells; and WHEREAS, cancer is the second leading cause of death in the State, with an average of 7,393 diagnoses of invasive cancer and 2,393 deaths annually; and WHEREAS, many cancers can be cured if detected and treated promptly, and other forms of cancer can be prevented by lifestyle changes; and WHEREAS, breast cancer remains the most frequently diagnosed cancer among women while prostate cancer remains the most frequently diagnosed cancer among men; and WHEREAS, disparities in cancer incidence are significant among Native Hawaiians, who have the highest lung cancer incidence and mortality rates, and Filipino women, who have the highest incidence for thyroid cancer; and WHEREAS, step therapy is a type of prior authorization that requires patients to try a certain, less expensive drug on a health insurance plan that has been proven effective before further treatments are authorized; and WHEREAS, however, step therapy may limit full access to effective treatment options at early stages of illness; and WHEREAS, section 23-51, Hawaii Revised Statutes, requires that "[b]efore any legislative measure that mandates health insurance coverage for specific health services, specific diseases, or certain providers of health care services as part of individual or group health insurance policies, can be considered, there shall be concurrent resolutions passed requesting the auditor to prepare and submit to the legislature a report that assesses both the social and financial effects of the proposed mandated coverage"; and WHEREAS, section 23-51, Hawaii Revised Statutes, further provides that "[t]he concurrent resolutions shall designate a specific legislative bill that: (1) Has been introduced in the legislature; and (2) Includes, at a minimum, information identifying the: (A) Specific health service, disease, or provider that would be covered; (B) Extent of the coverage; (C) Target groups that would be covered; (D) Limitations on utilization, if any; and (E) Standards of care. For purposes of this part, mandated health insurance coverage shall not include mandated optionals."; and WHEREAS, section 23-52, Hawaii Revised Statutes, further specifies the minimum information required for assessing the social and financial impact of the proposed health coverage mandate in the State Auditor's report; and WHEREAS, Senate Bill No. 2316, introduced in the Regular Session of 2024, proposes to prohibit health insurers that cover treatment for stage two through stage five cancer from the requirement that an insured diagnosed with stage two through stage five cancer to undergo step therapy before covering the drug prescribed to the insured by the insured's health care provider, including: (1) An investigational new drug; or (2) A prescription drug: (A) That is approved by the United States Food and Drug Administration; (B) Whose use is consistent with best practices for the treatment of the cancer in its respective stage; and (C) That is listed on the insurer's prescription drug formulary; and WHEREAS, the Legislature believes that prohibiting health insurers that cover treatment for stage two through stage five cancer from requiring an insured diagnosed with stage two through stage five cancer to undergo step therapy before covering the drug prescribed to the insured by the insured's health care provider will increase the likelihood of proactive treatment of cancer and save lives; now, therefore, BE IT RESOLVED by the House of Representatives of the Thirty-second Legislature of the State of Hawaii, Regular Session of 2024, the Senate concurring, that the Auditor is requested to conduct an impact assessment report in accordance with sections 23-51 and 23-52, Hawaii Revised Statutes, of prohibiting step therapy requirements in health insurance policies, contracts, plans, or agreements that cover the treatment of stage two through stage five cancer as proposed by Senate Bill No. 2316 (Regular Session of 2024); and BE IT FURTHER RESOLVED that the Auditor is further requested to include in its assessment the impact of section 1311(d)(3) of the federal Patient Protection and Affordable Care Act (PPACA) on Senate Bill No. 2316, or similar legislation, that includes but is not limited to the additional cost of any benefits beyond the essential health benefits of Hawaii's qualified health plans under the PPACA; and BE IT FURTHER RESOLVED that the Auditor is also requested to determine how many qualified health plans are available in Hawaii, including plans offered by health maintenance organizations; the individual or group enrollment in these plans; and the actuarial cost of the defrayment to the State for the prohibition of step therapy requirements for health plans that provide coverage of treatment of stage two through stage five cancer; and BE IT FURTHER RESOLVED that the Auditor is requested to submit a report on the Auditor's findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2025; and BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Auditor and Insurance Commissioner, who is requested to transmit copies to each insurer in the State that issues health insurance policies. OFFERED BY: _____________________________ Report Title: Auditor; Impact Assessment Report; Mandatory Health Insurance Coverage; Step Therapy; Cancer
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45	45	WHEREAS, cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells; and
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49	49	WHEREAS, cancer is the second leading cause of death in the State, with an average of 7,393 diagnoses of invasive cancer and 2,393 deaths annually; and
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53	53	WHEREAS, many cancers can be cured if detected and treated promptly, and other forms of cancer can be prevented by lifestyle changes; and
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57	57	WHEREAS, breast cancer remains the most frequently diagnosed cancer among women while prostate cancer remains the most frequently diagnosed cancer among men; and
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61	61	WHEREAS, disparities in cancer incidence are significant among Native Hawaiians, who have the highest lung cancer incidence and mortality rates, and Filipino women, who have the highest incidence for thyroid cancer; and
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65	65	WHEREAS, step therapy is a type of prior authorization that requires patients to try a certain, less expensive drug on a health insurance plan that has been proven effective before further treatments are authorized; and
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69	69	WHEREAS, however, step therapy may limit full access to effective treatment options at early stages of illness; and
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73	73	WHEREAS, section 23-51, Hawaii Revised Statutes, requires that "[b]efore any legislative measure that mandates health insurance coverage for specific health services, specific diseases, or certain providers of health care services as part of individual or group health insurance policies, can be considered, there shall be concurrent resolutions passed requesting the auditor to prepare and submit to the legislature a report that assesses both the social and financial effects of the proposed mandated coverage"; and
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77	77	WHEREAS, section 23-51, Hawaii Revised Statutes, further provides that "[t]he concurrent resolutions shall designate a specific legislative bill that:
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81	81	(1) Has been introduced in the legislature; and
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85	85	(2) Includes, at a minimum, information identifying the:
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89	89	(A) Specific health service, disease, or provider that would be covered;
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93	93	(B) Extent of the coverage;
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97	97	(C) Target groups that would be covered;
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101	101	(D) Limitations on utilization, if any; and
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105	105	(E) Standards of care.
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109	109	For purposes of this part, mandated health insurance coverage shall not include mandated optionals."; and
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113	113	WHEREAS, section 23-52, Hawaii Revised Statutes, further specifies the minimum information required for assessing the social and financial impact of the proposed health coverage mandate in the State Auditor's report; and
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117	117	WHEREAS, Senate Bill No. 2316, introduced in the Regular Session of 2024, proposes to prohibit health insurers that cover treatment for stage two through stage five cancer from the requirement that an insured diagnosed with stage two through stage five cancer to undergo step therapy before covering the drug prescribed to the insured by the insured's health care provider, including:
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121	121	(1) An investigational new drug; or
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125	125	(2) A prescription drug:
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129	129	(A) That is approved by the United States Food and Drug Administration;
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133	133	(B) Whose use is consistent with best practices for the treatment of the cancer in its respective stage; and
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137	137	(C) That is listed on the insurer's prescription drug formulary; and
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141	141	WHEREAS, the Legislature believes that prohibiting health insurers that cover treatment for stage two through stage five cancer from requiring an insured diagnosed with stage two through stage five cancer to undergo step therapy before covering the drug prescribed to the insured by the insured's health care provider will increase the likelihood of proactive treatment of cancer and save lives; now, therefore,
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145	145	BE IT RESOLVED by the House of Representatives of the Thirty-second Legislature of the State of Hawaii, Regular Session of 2024, the Senate concurring, that the Auditor is requested to conduct an impact assessment report in accordance with sections 23-51 and 23-52, Hawaii Revised Statutes, of prohibiting step therapy requirements in health insurance policies, contracts, plans, or agreements that cover the treatment of stage two through stage five cancer as proposed by Senate Bill No. 2316 (Regular Session of 2024); and
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149	149	BE IT FURTHER RESOLVED that the Auditor is further requested to include in its assessment the impact of section 1311(d)(3) of the federal Patient Protection and Affordable Care Act (PPACA) on Senate Bill No. 2316, or similar legislation, that includes but is not limited to the additional cost of any benefits beyond the essential health benefits of Hawaii's qualified health plans under the PPACA; and
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153	153	BE IT FURTHER RESOLVED that the Auditor is also requested to determine how many qualified health plans are available in Hawaii, including plans offered by health maintenance organizations; the individual or group enrollment in these plans; and the actuarial cost of the defrayment to the State for the prohibition of step therapy requirements for health plans that provide coverage of treatment of stage two through stage five cancer; and
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157	157	BE IT FURTHER RESOLVED that the Auditor is requested to submit a report on the Auditor's findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2025; and
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161	161	BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Auditor and Insurance Commissioner, who is requested to transmit copies to each insurer in the State that issues health insurance policies.
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169	169	OFFERED BY: _____________________________
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173	173	OFFERED BY:
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187	187	Report Title:
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189	189	Auditor; Impact Assessment Report; Mandatory Health Insurance Coverage; Step Therapy; Cancer