HB216

Hawaii HB216 regulates step therapy protocols in health insurance plans, ensuring they are based on clinical guidelines and allow for exceptions.

Hawaii HB216 mandates that health insurance plans using step therapy protocols base these protocols on clinical practice guidelines. These guidelines must be developed by multidisciplinary panels managing conflicts of interest and be based on high-quality studies. The bill ensures patients and providers can request exceptions to step therapy protocols, which must be processed within 72 hours, or 24 hours in urgent cases. Exceptions are granted if a patient's condition is stabilized by a specific drug, if switching drugs could cause harm, or if the prescribed drug was previously effective.