HB598

HOUSE OF REPRESENTATIVES	H.B. NO.	598
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:

SECTION 1. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A to be appropriately designated and to read as follows:

"§431:10A- Breast cancer screening, supplemental breast examinations, and diagnostic breast examinations; cost-sharing prohibited. (a) No individual or group accident and health or sickness insurance policy that provides coverage for breast cancer screening, supplemental breast examinations, or diagnostic breast examinations shall impose any cost-sharing requirements on the insured, except to the extent that coverage of particular services without cost-sharing would disqualify an individual covered under a high deductible health plan from being considered an eligible individual pursuant to section 223 of the Internal Revenue Code of 1986, as amended. For an individual covered under a high deductible health plan, the insurer shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the insured's eligibility under section 223 of the Internal Revenue Code of 1986, as amended; provided that, for items or services that are considered preventative care pursuant to section 223(c)(2)(C) of the Internal Revenue Code of 1986, as amended, the requirements of this subsection shall apply regardless of whether the minimum deductible under section 223(c)(2)(A) of the Internal Revenue Code of 1986, as amended, has been satisfied.

(b) As used in this section:

"Cost-sharing requirement" includes a deductible, a coinsurance, a copayment, and any maximum limitation on the application of the deductible, coinsurance, copayment, or similar out-of-pocket expense.

"Diagnostic breast examination" means a medically necessary and clinically appropriate examination of the breast that is:

(1) Used to evaluate an abnormality seen or suspected from a screening examination for breast cancer; or

(2) Used to evaluate an abnormality detected by another means of examination.

"Diagnostic breast examination" includes an examination using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound.

"Supplemental breast examination" means a medically necessary and appropriate examination of the breast that is:

(1) Used to screen for breast cancer in the absence of an abnormality being seen or suspected; and

(2) Based on personal or family medical history or any additional factors that may increase the individual's risk of breast cancer.

"Supplemental breast examination" includes an examination using breast magnetic resonance imaging or breast ultrasound."

SECTION 2. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article 1 to be appropriately designated and to read as follows:

"§432:1- Breast cancer screening, supplemental breast examinations, and diagnostic breast examinations; cost-sharing prohibited. (a) No individual or group hospital or medical service plan contract that provides coverage for breast cancer screening, supplemental breast examinations, or diagnostic breast examinations shall impose any cost-sharing requirements on the insured, except to the extent that coverage of particular services without cost-sharing would disqualify an individual covered under a high deductible health plan from being considered an eligible individual pursuant to section 223 of the Internal Revenue Code of 1986, as amended. For an individual covered under a high deductible health plan, the insurer shall establish the plan's cost-sharing for the coverage provided pursuant to this section at the minimum level necessary to preserve the insured's eligibility under section 223 of the Internal Revenue Code of 1986, as amended; provided that, for items or services that are considered preventative care pursuant to section 223(c)(2)(C) of the Internal Revenue Code of 1986, as amended, the requirements of this subsection shall apply regardless of whether the minimum deductible under section 223(c)(2)(A) of the Internal Revenue Code of 1986, as amended, has been satisfied.

HB 598: RELATING TO HEALTH.

Current Status:

News Coverage: