1 | 1 | | HOUSE OF REPRESENTATIVES H.B. NO. 641 THIRTY-THIRD LEGISLATURE, 2025 STATE OF HAWAII A BILL FOR AN ACT relating to health. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII: |
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3 | 3 | | HOUSE OF REPRESENTATIVES H.B. NO. 641 |
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4 | 4 | | THIRTY-THIRD LEGISLATURE, 2025 |
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5 | 5 | | STATE OF HAWAII |
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7 | 7 | | HOUSE OF REPRESENTATIVES |
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9 | 9 | | H.B. NO. |
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11 | 11 | | 641 |
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13 | 13 | | THIRTY-THIRD LEGISLATURE, 2025 |
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17 | 17 | | STATE OF HAWAII |
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30 | 30 | | |
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31 | 31 | | A BILL FOR AN ACT |
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37 | 37 | | relating to health. |
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43 | 43 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII: |
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47 | 47 | | SECTION 1. The legislature finds that multiple federally qualified health centers and native Hawaiian health care systems in the State offer traditional healing practices. For example, Waimanalo Health Center integrates traditional healing practices such as lomilomi massage and laau lapaau along with western health care services. A patient on blood pressure medication may work concurrently with a traditional healer to make lifestyle changes such as diet, exercise, meditation, and growing herbs for their own treatment to support or reduce dependence on the medication. The Kokua Kalihi Valley Health Center provides an eight-week birthing education series focused on reclaiming ancestral practices and the cultivation of connection as ways to nurture healthy, happy births. The center also integrates several traditional healing practices such as lomilomi, ai pono, laau lapaau, and hooponopono. The legislature further finds that currently only two providers voluntarily cover traditional native Hawaiian healing and cultural practices in collaboration with certain community health centers, native Hawaiian health care systems, and cultural practitioners. The purpose of this Act is to require coverage of traditional native Hawaiian healing and cultural practices when those services are provided at federally qualified health centers or native Hawaiian health care systems. SECTION 2. 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- Traditional native Hawaiian healing and cultural practices; coverage; requirements. (a) Every individual or group policy of accident and health or sickness insurance issued or renewed in this State on or after January 1, 2026, shall provide coverage for traditional native Hawaiian healing and cultural practices provided at a federally qualified health center or native Hawaiian health care system for the policyholder and any dependent of the policyholder who is covered by the policy. (b) Coverage under this section shall be subject to copayment, deductible, and coinsurance provisions of the policy that are no less favorable than the copayment, deductible, and coinsurance provisions for substantially all other medical services covered by the policy. (c) Coverage for services required by this section shall include reimbursement to providers who provide traditional native Hawaiian healing and cultural practices at a federally qualified health center or native Hawaiian health care system. (d) If the coverage required by this section is provided by an out-of-network provider, the insurer shall cover the coverage without imposing any cost-sharing requirement on the policyholder if: (1) There is no in-network provider to furnish the coverage that meets the requirements for network adequacy under section 431:26-103; or (2) An in-network provider is unable or unwilling to provide the coverage in a timely manner. (e) Every insurer shall provide notice to its policyholders regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to policyholders and shall be transmitted to policyholders beginning with calendar year 2026 when annual information is made available to policyholders or in any other mailing to policyholders, but in no case later than December 31, 2026. (f) This section shall not require a policy of accident and health or sickness insurance to cover traditional native Hawaiian healing and cultural practices provided outside of a federally qualified health center or native Hawaiian health care system. (g) This section shall not apply to limited benefit health insurance as provided in section 431:l0A-607. (h) For purposes of this section: "Federally qualified health center" has the same meaning as defined in section 1905(l) of the Social Security Act (42 U.S.C. 1396 et seq.). "Native Hawaiian health care system" means the Native Hawaiian Health Care Systems Program administered by the United States Health Resources and Services Administration and funded under the federal Native Hawaiian Health Care Act of 1988 (42 U.S.C. 11701 et. seq.). "Native Hawaiian health care system" includes native Hawaiian health centers and Papa Ola Lokahi. "Traditional native Hawaiian healing and cultural practices" includes but is not limited to hooponopono, lomilomi massage, ai pono, and laau lapaaau." SECTION 3. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section article 1 to be appropriately designated and to read as follows: "§432:1- Traditional native Hawaiian healing and cultural practices; coverage; requirements. (a) Every individual or group hospital or medical service plan contract issued or renewed in this State on or after January 1, 2026, shall provide coverage for traditional native Hawaiian healing and cultural practices provided at a federally qualified health center or native Hawaiian health care system for the subscriber or member and any dependent of the subscriber or member who is covered by the policy. (b) Coverage under this section shall be subject to copayment, deductible, and coinsurance provisions of the policy that are no less favorable than the copayment, deductible, and coinsurance provisions for substantially all other medical services covered by the plan contract. (c) Coverage for services required by this section shall include reimbursement to providers who provide traditional native Hawaiian healing and cultural practices at a federally qualified health center or native Hawaiian health care system. (d) If the coverage required by this section is provided by an out-of-network provider, the mutual benefit society shall cover the coverage without imposing any cost-sharing requirement on the subscriber or member if: (1) There is no in-network provider to furnish the coverage that meets the requirements for network adequacy under section 431:26-103; or (2) An in-network provider is unable or unwilling to provide the coverage in a timely manner. (e) Every mutual benefit society shall provide notice to its subscribers and members regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to subscribers and members and shall be transmitted to subscribers and members beginning with calendar year 2026 when annual information is made available to subscribers and members or in any other mailing to subscribers and members, but in no case later than December 31, 2026. (f) This section shall not require an individual or group hospital or medical service plan contract to cover traditional native Hawaiian healing and cultural practices provided outside of a federally qualified health center or native Hawaiian health care system. (g) For purposes of this section: "Federally qualified health center" has the same meaning as defined in section 1905(l) of the Social Security Act (42 U.S.C. 1396 et seq.). "Native Hawaiian health care system" means the Native Hawaiian Health Care Systems Program administered by the United States Health Resources and Services Administration and funded under the federal Native Hawaiian Health Care Act of 1988 (42 U.S.C. 11701 et. seq.). "Native Hawaiian health care system" includes native Hawaiian health centers and Papa Ola Lokahi. "Traditional native Hawaiian healing and cultural practices" includes but is not limited to hooponopono, lomilomi massage, ai pono, and laau lapaaau." SECTION 4. New statutory material is underscored. SECTION 5. This Act shall take effect on January 1, 2026, and shall apply to all plans, policies, contracts, and agreements of health insurance issued or renewed by a health insurer or mutual benefit society on or after January 1, 2026. INTRODUCED BY: _____________________________ |
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48 | 48 | | |
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49 | 49 | | SECTION 1. The legislature finds that multiple federally qualified health centers and native Hawaiian health care systems in the State offer traditional healing practices. For example, Waimanalo Health Center integrates traditional healing practices such as lomilomi massage and laau lapaau along with western health care services. A patient on blood pressure medication may work concurrently with a traditional healer to make lifestyle changes such as diet, exercise, meditation, and growing herbs for their own treatment to support or reduce dependence on the medication. The Kokua Kalihi Valley Health Center provides an eight-week birthing education series focused on reclaiming ancestral practices and the cultivation of connection as ways to nurture healthy, happy births. The center also integrates several traditional healing practices such as lomilomi, ai pono, laau lapaau, and hooponopono. |
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50 | 50 | | |
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51 | 51 | | The legislature further finds that currently only two providers voluntarily cover traditional native Hawaiian healing and cultural practices in collaboration with certain community health centers, native Hawaiian health care systems, and cultural practitioners. |
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52 | 52 | | |
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53 | 53 | | The purpose of this Act is to require coverage of traditional native Hawaiian healing and cultural practices when those services are provided at federally qualified health centers or native Hawaiian health care systems. |
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54 | 54 | | |
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55 | 55 | | SECTION 2. 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: |
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56 | 56 | | |
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57 | 57 | | "§431:10A- Traditional native Hawaiian healing and cultural practices; coverage; requirements. (a) Every individual or group policy of accident and health or sickness insurance issued or renewed in this State on or after January 1, 2026, shall provide coverage for traditional native Hawaiian healing and cultural practices provided at a federally qualified health center or native Hawaiian health care system for the policyholder and any dependent of the policyholder who is covered by the policy. |
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58 | 58 | | |
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59 | 59 | | (b) Coverage under this section shall be subject to copayment, deductible, and coinsurance provisions of the policy that are no less favorable than the copayment, deductible, and coinsurance provisions for substantially all other medical services covered by the policy. |
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60 | 60 | | |
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61 | 61 | | (c) Coverage for services required by this section shall include reimbursement to providers who provide traditional native Hawaiian healing and cultural practices at a federally qualified health center or native Hawaiian health care system. |
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62 | 62 | | |
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63 | 63 | | (d) If the coverage required by this section is provided by an out-of-network provider, the insurer shall cover the coverage without imposing any cost-sharing requirement on the policyholder if: |
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65 | 65 | | (1) There is no in-network provider to furnish the coverage that meets the requirements for network adequacy under section 431:26-103; or |
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67 | 67 | | (2) An in-network provider is unable or unwilling to provide the coverage in a timely manner. |
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68 | 68 | | |
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69 | 69 | | (e) Every insurer shall provide notice to its policyholders regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to policyholders and shall be transmitted to policyholders beginning with calendar year 2026 when annual information is made available to policyholders or in any other mailing to policyholders, but in no case later than December 31, 2026. |
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71 | 71 | | (f) This section shall not require a policy of accident and health or sickness insurance to cover traditional native Hawaiian healing and cultural practices provided outside of a federally qualified health center or native Hawaiian health care system. |
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72 | 72 | | |
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73 | 73 | | (g) This section shall not apply to limited benefit health insurance as provided in section 431:l0A-607. |
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74 | 74 | | |
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75 | 75 | | (h) For purposes of this section: |
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76 | 76 | | |
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77 | 77 | | "Federally qualified health center" has the same meaning as defined in section 1905(l) of the Social Security Act (42 U.S.C. 1396 et seq.). |
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78 | 78 | | |
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79 | 79 | | "Native Hawaiian health care system" means the Native Hawaiian Health Care Systems Program administered by the United States Health Resources and Services Administration and funded under the federal Native Hawaiian Health Care Act of 1988 (42 U.S.C. 11701 et. seq.). "Native Hawaiian health care system" includes native Hawaiian health centers and Papa Ola Lokahi. |
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80 | 80 | | |
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81 | 81 | | "Traditional native Hawaiian healing and cultural practices" includes but is not limited to hooponopono, lomilomi massage, ai pono, and laau lapaaau." |
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82 | 82 | | |
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83 | 83 | | SECTION 3. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section article 1 to be appropriately designated and to read as follows: |
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84 | 84 | | |
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85 | 85 | | "§432:1- Traditional native Hawaiian healing and cultural practices; coverage; requirements. (a) Every individual or group hospital or medical service plan contract issued or renewed in this State on or after January 1, 2026, shall provide coverage for traditional native Hawaiian healing and cultural practices provided at a federally qualified health center or native Hawaiian health care system for the subscriber or member and any dependent of the subscriber or member who is covered by the policy. |
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86 | 86 | | |
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87 | 87 | | (b) Coverage under this section shall be subject to copayment, deductible, and coinsurance provisions of the policy that are no less favorable than the copayment, deductible, and coinsurance provisions for substantially all other medical services covered by the plan contract. |
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88 | 88 | | |
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89 | 89 | | (c) Coverage for services required by this section shall include reimbursement to providers who provide traditional native Hawaiian healing and cultural practices at a federally qualified health center or native Hawaiian health care system. |
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90 | 90 | | |
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91 | 91 | | (d) If the coverage required by this section is provided by an out-of-network provider, the mutual benefit society shall cover the coverage without imposing any cost-sharing requirement on the subscriber or member if: |
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92 | 92 | | |
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93 | 93 | | (1) There is no in-network provider to furnish the coverage that meets the requirements for network adequacy under section 431:26-103; or |
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94 | 94 | | |
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95 | 95 | | (2) An in-network provider is unable or unwilling to provide the coverage in a timely manner. |
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96 | 96 | | |
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97 | 97 | | (e) Every mutual benefit society shall provide notice to its subscribers and members regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to subscribers and members and shall be transmitted to subscribers and members beginning with calendar year 2026 when annual information is made available to subscribers and members or in any other mailing to subscribers and members, but in no case later than December 31, 2026. |
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98 | 98 | | |
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99 | 99 | | (f) This section shall not require an individual or group hospital or medical service plan contract to cover traditional native Hawaiian healing and cultural practices provided outside of a federally qualified health center or native Hawaiian health care system. |
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100 | 100 | | |
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101 | 101 | | (g) For purposes of this section: |
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102 | 102 | | |
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103 | 103 | | "Federally qualified health center" has the same meaning as defined in section 1905(l) of the Social Security Act (42 U.S.C. 1396 et seq.). |
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104 | 104 | | |
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105 | 105 | | "Native Hawaiian health care system" means the Native Hawaiian Health Care Systems Program administered by the United States Health Resources and Services Administration and funded under the federal Native Hawaiian Health Care Act of 1988 (42 U.S.C. 11701 et. seq.). "Native Hawaiian health care system" includes native Hawaiian health centers and Papa Ola Lokahi. |
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106 | 106 | | |
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107 | 107 | | "Traditional native Hawaiian healing and cultural practices" includes but is not limited to hooponopono, lomilomi massage, ai pono, and laau lapaaau." |
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108 | 108 | | |
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109 | 109 | | SECTION 4. New statutory material is underscored. |
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110 | 110 | | |
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111 | 111 | | SECTION 5. This Act shall take effect on January 1, 2026, and shall apply to all plans, policies, contracts, and agreements of health insurance issued or renewed by a health insurer or mutual benefit society on or after January 1, 2026. |
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115 | 115 | | INTRODUCED BY: _____________________________ |
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117 | 117 | | INTRODUCED BY: |
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119 | 119 | | _____________________________ |
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125 | 125 | | Report Title: Health Insurance; Traditional Native Hawaiian Healing and Cultural Practices; Mandatory Coverage; Federally Qualified Health Centers; Native Hawaiian Health Care Systems Description: Beginning 1/1/2026, requires health insurers and mutual benefit societies to provide coverage for traditional native Hawaiian healing and cultural practices offered through a Federally Qualified Health Center or a Native Hawaiian Health Care System. The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent. |
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126 | 126 | | |
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127 | 127 | | |
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128 | 128 | | |
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129 | 129 | | |
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130 | 130 | | |
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131 | 131 | | Report Title: |
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132 | 132 | | |
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133 | 133 | | Health Insurance; Traditional Native Hawaiian Healing and Cultural Practices; Mandatory Coverage; Federally Qualified Health Centers; Native Hawaiian Health Care Systems |
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134 | 134 | | |
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135 | 135 | | |
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136 | 136 | | |
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137 | 137 | | Description: |
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138 | 138 | | |
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139 | 139 | | Beginning 1/1/2026, requires health insurers and mutual benefit societies to provide coverage for traditional native Hawaiian healing and cultural practices offered through a Federally Qualified Health Center or a Native Hawaiian Health Care System. |
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140 | 140 | | |
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141 | 141 | | |
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142 | 142 | | |
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143 | 143 | | |
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144 | 144 | | |
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145 | 145 | | |
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146 | 146 | | |
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147 | 147 | | The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent. |
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