Hawaii HB216 regulates step therapy protocols for prescription drugs to ensure fair and transparent coverage decisions.

Hawaii HB216 amends state statutes to establish requirements for step therapy protocols used by insurers and utilization review organizations. These protocols, which require patients to try certain prescription drugs before coverage is provided for others, must be based on clinical practice guidelines. Insurers and organizations must make exception requests transparent and accessible, and must respond to requests within 72 hours. The bill also mandates annual reporting on step therapy exceptions and requires the insurance division to adopt necessary rules.

Hawaii HB216 regulates step therapy protocols for prescription drugs to ensure fair and transparent coverage decisions.

Hawaii HB216 amends state statutes to establish requirements for step therapy protocols used by insurers and utilization review organizations. These protocols, which require patients to try certain prescription drugs before coverage is provided for others, must be based on clinical practice guidelines. Insurers and organizations must make exception requests transparent and accessible, and must respond to requests within 72 hours. The bill also mandates annual reporting on step therapy exceptions and requires the insurance division to adopt necessary rules.