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HB1864
HOUSE OF REPRESENTATIVES
H.B. NO.
1864
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:
����
SECTION 1.
�
Chapter 431, Hawaii Revised Statutes, is
amended by adding a new section to article 10A, part I, to be appropriately
designated and to read as follows:
����
"
�431:10A-
�
Standard fertility preservation services coverage.
�
(a)
�
Each individual or group policy of accident
and health or sickness insurance issued or renewed in the State after
December 31, 2026, shall provide to the policyholder, and individuals
under twenty-six years of age covered under the policy, coverage for standard
fertility preservation services for any insured who may undergo a medically
necessary treatment that may directly or indirectly cause iatrogenic
infertility.
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(b)
�
No policy that provides coverage for standard
fertility preservation services as required by subsection (a) shall:
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(1)
�
Use any prior
diagnosis or prior fertility treatment as a basis for excluding, limiting, or
otherwise restricting the availability of the required coverage; or
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(2)
�
Discriminate
based on the insured's expected length of life, present or predicted
disability, degree of medical dependency, perceived quality of life, or other
health conditions.
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(c)
�
Any limitations imposed by a policy shall be
based on the insured's medical history and clinical guidelines adopted by the
insurer.
�
Any clinical guidelines used by
the insurer shall be based on the 2018 update to the American Society of
Clinical Oncology guidelines and shall not deviate from the full scope of the
guidelines.
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(d)
�
For the purposes of this section:
����
"
American Society of
Clinical Oncology guidelines" means the clinical practice guidelines on
fertility preservation in people with cancer published by the American Society
of Clinical Oncology.
����
"Iatrogenic
infertility" means an impairment of fertility caused directly or
indirectly by surgery, chemotherapy, radiation, or other medical treatment
affecting the reproductive organs or processes.
����
"Medically necessary
treatment that may directly or indirectly cause iatrogenic infertility"
means any cancer‑related medical treatment with a likely side effect of
infertility.
����
"Standard fertility
preservation services" means the procedures to preserve fertility as
outlined and established according to the 2018 update to the American Society
of Clinical Oncology guidelines.
�
"Standard fertility preservation services" include the full
scope of services or treatments, without any exclusions or limitations, as
defined in the 2018 update to the American Society of Clinical Oncology
guidelines.
�
"Standard
fertility preservation services"
does not include:
����
(1)
�
Any
experimental procedures or other procedures not determined to be established
medical practices according to the 2018 update to the American Society of
Clinical Oncology guidelines;
����
(2)
�
Third-party assisted
reproduction technology procedures, including donor egg or surrogates and
gestational carriers; and
����
(3)
�
Any services
relating to cryopreservation storage.
"
����
SECTION 2.
�
Chapter 432, Hawaii Revised Statutes, is
amended by adding a new section to article I, part VI, to be appropriately
designated and to read as follows:
����
"
�
432:1-
�
Standard fertility preservation services coverage.
�
(a)
�
Each individual or group hospital or medical
service plan contract issued or renewed in this State after December 31,
2026, shall provide to the subscriber or member, and individuals under
twenty-six years of age covered under the plan contract, coverage for standard
fertility preservation services for any covered person who may undergo a
medically necessary treatment that may directly or indirectly cause iatrogenic
infertility.
����
(b)
�
No plan contract that provides
coverage for standard fertility preservation services as required by subsection
(a) shall:
����
(1)
�
Use any prior
diagnosis or prior fertility treatment as a basis for excluding, limiting, or
otherwise restricting the availability of the required coverage; or
����
(2)
�
Discriminate
based on the covered person's expected length of life, present or predicted
disability, degree of medical dependency, perceived quality of life, or other
health conditions.
����
(c)
�
Any limitations imposed by a plan contract
shall be based on the covered person's medical history and clinical guidelines
adopted by the mutual benefit society.
�
Any clinical guidelines used by the mutual benefit society shall be
based on the 2018 update to the American Society of Clinical Oncology
guidelines and shall not deviate from the full scope of the guidelines.
����
(d)
�
For the purposes of this section:
����
"
American Society of
Clinical Oncology guidelines" means the clinical practice guidelines on
fertility preservation in people with cancer published by the American Society
of Clinical Oncology.
����
"Iatrogenic
infertility" means an impairment of fertility caused directly or
indirectly by surgery, chemotherapy, radiation, or other medical treatment
affecting the reproductive organs or processes.
����
"
Medically
necessary treatment that may directly or indirectly cause iatrogenic
infertility
" means
any cancer‑related medical treatment
with a likely side effect of infertility
.
����
"Standard fertility
preservation services" means the procedures to preserve fertility as
outlined and established according to 2018 update to the American Society of
Clinical Oncology guidelines.
�
"Standard fertility preservation services" include the full
scope of services or treatments, without any exclusions or limitations, as
defined in the 2018 update to the American Society of Clinical Oncology
guidelines.
�
"Standard fertility
preservation services" does not include:
����
(1)
�
Any
experimental procedures or other procedures not determined to be established
medical practices according to the 2018 update to the American Society of
Clinical Oncology guidelines;
����
(2)
�
Third-party assisted
reproduction technology procedures, including donor egg or surrogates and
gestational carriers; and
����
(3)
�
Any services
relating to cryopreservation storage.
"
����
SECTION
3
.
�
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 4.
�
The benefit to be provided by health
maintenance organizations corresponding to the benefit provided under section
431:10A- , Hawaii Revised Statutes, as contained in the
amendment to section 432D-23, Hawaii Revised Statutes, in section 3 of this
Act, shall take effect for all policies, contracts, plans, or agreements issued
or renewed in the State on or after December 31, 2026.
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SECTION 5.
�
Statutory material to be repealed is
bracketed and stricken.
�
New statutory
material is underscored.
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SECTION 6.
�
This Act shall take effect upon its approval.
INTRODUCED BY:
_____________________________
Report Title:
Insurance;
Mandatory Coverage; Standard Fertility Preservation Services; Iatrogenic
Infertility; Medically Necessary Treatment
Description:
For
policies, contracts, plans, and agreements issued or renewed after 12/31/2026,
requires insurers, mutual benefit societies, and health maintenance
organizations to provide coverage for standard fertility preservation services
for persons undergoing medically necessary treatment that may cause iatrogenic
infertility.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.