| 41 | | - | WHEREAS, Hawaii continues to face a shortage of health care providers, particularly in rural areas and the neighbor islands; and WHEREAS, pharmacies serve as a vital resource for health care delivery in the State because they are conveniently located and easily accessible to underserved communities; and WHEREAS, pharmacists today play an increasingly vital role in health care and can provide patient care services beyond the traditional role of dispensing prescription medication, such as medication therapy management, immunizations, health screenings, chronic disease management, and patient education and counseling; and WHEREAS, pharmacists perform these functions in concurrence with health care facilities and in accordance with policies, procedures, and protocols developed collaboratively by health professionals, including physicians, surgeons, and registered nurses, and for which pharmacists have received appropriate training to perform; and WHEREAS, pharmacies can help with cost savings by preventing hospital readmissions and managing chronic conditions, thereby reducing the overall cost of health care and increasing positive patient outcomes; and WHEREAS, reimbursements to pharmacies and registered pharmacists who safely provide health care services within their scope of practice is cost effective and brings the State closer to meeting the health care needs of the community, while strengthening the integrated care team model that has been proven effective for many of the State's most vulnerable patients; and WHEREAS, in 2023, the Office of the Auditor issued a report assessing the social and financial impacts of mandating health insurance coverage for services provided by pharmacists; and WHEREAS, the Legislature finds that reimbursement from patients' health plans is the next step to ensure that pharmacists in the State can maximize their clinical services and practice within their full scope of licensure pursuant to chapter 461, Hawaii Revised Statutes; now, therefore, BE IT RESOLVED by the Senate of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2025, that the Director of Commerce and Consumer Affairs is requested to establish a Pharmacy Reimbursement Working Group to study mandatory health insurance coverage and payment for health care services provided by pharmacists and to propose legislation mandating reimbursement for pharmacy services to be introduced in the Regular Session of 2026; and BE IT FURTHER RESOLVED that the Director of Commerce and Consumer Affairs is requested to invite the Insurance Commissioner, or the Insurance Commissioner's designee; one representative of the Board of Pharmacy; two representatives from the retail pharmacy community; one representative from an independent pharmacists' association; and two representatives from the health insurance industry, to participate as members of the Working Group; and BE IT FURTHER RESOLVED that the Pharmacy Reimbursement Working Group is requested to: (1) Meet regularly to gather information about pharmacy reimbursement practices with the goal of requiring reimbursement for health care services provided by pharmacists acting within their scope of practice in the State; (2) Discuss the impact of reimbursement for pharmacists providing health care services in the State and examine whether the lack of reimbursement poses a hardship on individuals needing treatment, the extent to which the proposed mandatory insurance coverage would impact access to care in the State, and the impact of providing coverage for the treatment or service to the pharmacist or pharmacy; (3) Draft proposed legislation that would require health insurers in the State to provide coverage for health care services provided by licensed pharmacists acting within their scope of practice and fairly reimburse pharmacies or pharmacists for those services provided within their scope of practice under chapter 461, Hawaii Revised Statutes; and (4) Evaluate pharmacists in other jurisdictions and the kind of services being provided within their scope of practice and whether those services would have a significant impact on preventative care services in the State; and BE IT FURTHER RESOLVED that the Pharmacy Reimbursement Working Group submit a written report of its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2026; and BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of Commerce and Consumer Affairs, Insurance Commissioner, and Executive Officer of the Board of Pharmacy. Report Title: Pharmacy Reimbursement Working Group |
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| 41 | + | WHEREAS, Hawaii continues to face a shortage of health care providers, particularly in rural areas and the neighbor islands; and WHEREAS, pharmacies serve as a vital resource for health care delivery in the State because they are conveniently located and easily accessible to underserved communities; and WHEREAS, pharmacists today play an increasingly vital role in health care and can provide patient care services beyond the traditional role of dispensing prescription medication, such as medication therapy management, immunizations, health screenings, chronic disease management, and patient education and counseling; and WHEREAS, pharmacists perform these functions in concurrence with health care facilities and in accordance with policies, procedures, and protocols developed collaboratively by health professionals, including physicians, surgeons, and registered nurses, and for which pharmacists have received appropriate training to perform; and WHEREAS, pharmacies can help with cost savings by preventing hospital readmissions and managing chronic conditions, thereby reducing the overall cost of health care and increasing positive patient outcomes; and WHEREAS, reimbursements to pharmacies and registered pharmacists who safely provide health care services within their scope of practice is cost effective and brings the State closer to meeting the health care needs of the community, while strengthening the integrated care team model that has been proven effective for many of the State's most vulnerable patients; and WHEREAS, in 2023, the Office of the Auditor issued a report assessing the social and financial impacts of mandating health insurance coverage for services provided by pharmacists; and WHEREAS, the Legislature finds that reimbursement from patients' health plans is the next step to ensure that pharmacists in the State can maximize their clinical services and practice within their full scope of licensure pursuant to chapter 461, Hawaii Revised Statutes; now, therefore, BE IT RESOLVED by the Senate of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2025, that the Director of Commerce and Consumer Affairs is requested to establish a Pharmacy Reimbursement Working Group to study mandatory health insurance coverage and payment for health care services provided by pharmacists and to propose legislation mandating reimbursement for pharmacy services to be introduced in the Regular Session of 2026; and BE IT FURTHER RESOLVED that the Director of Commerce and Consumer Affairs is requested to invite the Insurance Commissioner, one representative of the Board of Pharmacy, two representatives from the retail pharmacy community, one representative from an independent pharmacists' association, and two representatives from the health insurance industry to participate as members of the Working Group; and BE IT FURTHER RESOLVED that the Pharmacy Reimbursement Working Group is requested to: (1) Meet regularly to gather information about pharmacy reimbursement practices with the goal of requiring reimbursement for health care services provided by pharmacists acting within their scope of practice in the State; (2) Discuss the impact of reimbursement for pharmacists providing health care services in the State and examine whether the lack of reimbursement poses a hardship on individuals needing treatment, the extent to which the proposed mandatory insurance coverage would impact access to care in the State, and the impact of providing coverage for the treatment or service to the pharmacist or pharmacy; (3) Draft proposed legislation that would require health insurers in the State to provide coverage for health care services provided by licensed pharmacists acting within their scope of practice, and to fairly reimburse pharmacies or pharmacists for those services provided within their scope of practice under chapter 461, Hawaii Revised Statutes; and (4) Evaluate pharmacists in other jurisdictions and the kind of services being provided within their scope of practice and whether those services would have a significant impact on preventative care services in the State; and BE IT FURTHER RESOLVED that the Pharmacy Reimbursement Working Group submit a written report of its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2026; and BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of Commerce and Consumer Affairs, Insurance Commissioner, and Executive Officer of the Board of Pharmacy. OFFERED BY: _____________________________ Report Title: Pharmacy Reimbursement Working Group |
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