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HB1702
HOUSE OF REPRESENTATIVES
H.B. NO.
1702
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII
A BILL FOR AN ACT
relating
to insurance
.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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SECTION 1.
�
The legislature finds that cognitive
assessments are crucial for early detection and management of cognitive
impairments such as dementia and Alzheimer's disease.
�
Early diagnosis can significantly improve the
quality of life for affected individuals and reduce long-term health care
costs.
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The legislature further finds that research
shows that certain populations face elevated risks for developing dementia.
�
By age forty, most individuals with Down
syndrome have beta-amyloid plaques and
tau
tangles in
the brain, which disrupt normal cell function and
significantly increase the likelihood of Alzheimer's
symptoms
.
�
Estimates
s
u
ggest that fifty per cent
or more of individuals with Down syndrome will develop dementia due to
Alzheimer's disease as they age.
����
The legislature additionally finds
that Native Hawaiians suffer from higher rates of Alzheimer's disease and
related dementias; are often diagnosed at younger ages; and despite earlier
diagnosis, tend to be in later stages of the disease at the time of
detection.
�
This disparity underscores
the urgent need for proactive screening and intervention.
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Furthermore, common risk factors
such as diabetes, hypertension, smoking, lack of physical activity, and poor
diet contribute to cognitive decline and increase the likelihood of dementia.
�
Detecting cognitive changes early allows
health care providers to address these risks preventively, implement care
planning, and connect individuals to supportive services before significant
decline occurs.
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Moreover, the legislature notes that
when health care providers order certain evidence-based preventive services, such
as a brief emotional and behavioral assessment, these are widely reimbursed at
a modest rate by medicare, medicaid, and private insurance, incentivizing early
detection and intervention for behavioral health.
�
Similarly, coverage for brief cognitive
assessments would provide a cost-effective mechanism to identify cognitive
changes early, reduce long-term health care costs, and improve outcomes for
individuals at risk of dementia.
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Therefore, the purpose of this Act
is to require insurance coverage for brief cognitive assessments for
individuals fifty years of age and older during routine and nonroutine visits,
ensuring that cognitive changes are identified early and managed effectively.
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SECTION 2.
�
Chapter 431, Hawaii Revised Statutes, is
amended by adding a new section to article 10A to be appropriately designated
and to read as follows:
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"
�431:10A-
�
Cognitive assessments; coverage.
�
(a)
�
Each individual or group policy of accident
and health or sickness insurance issued or renewed in the State on or after
January 1, 2027, shall provide coverage for brief cognitive assessment
screening for the policyholder or any dependent of the policyholder covered under
the policy.
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(b)
�
Coverage
required under this section shall include but not be limited to:
����
(1)
�
Initial cognitive
assessments during routine visits for individuals fifty years of age and older;
and
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(2)
�
Initial cognitive
assessments during non-routine visits for individuals fifty years of age and
older.
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(c)
�
This section shall not prohibit an insurer
from providing coverage that is greater or more favorable to the policyholder
and any dependent of the policyholder covered under the policy.
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(d)
�
Coverage required under this section may be
subject to deductibles, copayments, coinsurance, or annual or maximum payment
limits that are consistent with deductibles, copayments, coinsurance, and
annual or maximum payment limits applicable to other similar coverage under the
policy.
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(e)
�
Annual information that is made available to
policyholders shall include information concerning the coverage required by
this section.
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(f)
�
This section shall not apply to limited
benefit health insurance as provided in section 431:10A-607.
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(g)
�
As
used in this section:
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"Cognitive assessment" means a
validated evaluation of an individual's cognitive functions, including memory,
attention, language, and problem-solving abilities, conducted using validated
tools and procedures.
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"Screening" means the process of
identifying individuals who may be at risk for cognitive impairments through
brief, validated tests.
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"Validated tools" means assessment
instruments that have been scientifically tested and proven to accurately
measure cognitive functions.
"
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SECTION 3.
�
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-
�
Cognitive
assessments; coverage.
�
(a)
�
Each individual or group hospital or medical service plan contract
issued or renewed in the State on or after January 1, 2027, shall provide
coverage for brief cognitive assessment screening for the subscriber or member
or any dependent of the subscriber or member covered under the plan contract.
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(b)
�
Coverage for brief cognitive assessments shall include but not be
limited to:
����
(1)
�
Initial cognitive
assessments during routine visits for individuals fifty years of age and older;
and
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(2)
�
Initial cognitive
assessments during non-routine visits for individuals fifty years of age and
older.
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(c)
�
This section shall not prohibit a mutual
benefit society from providing coverage that is greater or more favorable to
the subscriber or member and any dependent of the subscriber or member covered
under the plan contract.
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(d)
�
Coverage required under this section may be
subject to deductibles, copayments, coinsurance, or annual or maximum payment
limits that are consistent with deductibles, copayments, coinsurance, and
annual or maximum payment limits applicable to other similar coverage under the
plan contract.
����
(e)
�
Annual information that is made available to
subscribers and members shall include information concerning the coverage
required by this section.
����
(f)
�
As
used in this section:
����
"Cognitive assessment" means a
validated evaluation of an individual's cognitive functions, including memory,
attention, language, and problem-solving abilities, conducted using validated
tools and procedures.
����
"Screening" means the process of
identifying individuals who may be at risk for cognitive impairments through
brief, validated tests.
����
"Validated tools" means assessment
instruments that have been scientifically tested and proven to accurately
measure cognitive functions.
"
����
SECTION
4
.
�
Section
432D-23, Hawaii Revised Statutes, is amended to read as follows:
����
"
�432D-23
�
Required provisions and
benefits.
�
Notwithstanding any
provision of law to the contrary, each policy, contract, plan, or agreement
issued in the State after January 1, 1995, by health maintenance organizations
pursuant to this chapter, shall include benefits provided in sections
431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2,
431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121,
431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133,
431:10A-134,
431:10A-140, and [
431:10A-134,
]
431:10A- ,
and
chapter 431M."
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SECTION 5.
�
The benefits and coverage to be provided by
health maintenance organizations under section 4 of this Act shall take effect
for all policies, contracts, plans, or agreements issued or renewed in the
State on or after January 1, 2027.
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SECTION 6.
�
(a)
�
The reimbursement for brief cognitive assessments for individuals fifty
years of age and older required under sections 2 and 3 of this Act shall apply
to all health plans under the medicaid managed care program in the State.
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(b)
�
The department of human services shall submit the necessary amendments
to the Hawaii medicaid state plan to the Centers for Medicare and Medicaid
Services no later than
.
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SECTION 7.
�
Statutory material to be repealed is
bracketed and stricken.
�
New statutory
material is underscored.
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SECTION 8.
�
This Act shall take effect on July 1, 2026;
provided that section 6 of this Act shall take effect upon approval of the
Hawaii medicaid state plan by the Centers for Medicare and Medicaid Services.
INTRODUCED BY:
_____________________________
Report Title:
Health Insurance;
Brief Cognitive Assessments; Mandatory Coverage; Health Insurers; Mutual
Benefit Societies; Health Maintenance Organizations; Medicaid
Description:
Beginning 1/1/2027, requires health insurers, mutual
benefit societies, health maintenance organizations, and health plans under the
State's Medicaid managed care program to provide coverage for brief cognitive
assessments for individuals fifty years of age and older.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.