HB2224 • 2026

RELATING TO MEDICAID.

Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor: GRANDINETTI, AMATO, BELATTI, HUSSEY, ILAGAN, IWAMOTO, KAPELA, MATAYOSHI, PERRUSO, POEPOE, TAKAYAMA, TEMPLO
Last action: 2026-02-18
Official status: Passed Second Reading as amended in HD 1 and referred to the committee(s) on FIN with none voting aye with reservations; none voting no (0) and none excused (0).
Effective date: Not listed

Plain English Breakdown

The bill summary does not provide specific details about the new methods of managing pharmaceutical benefits or how they would work.

Medicaid Changes: Pharmaceutical Benefits Management

This bill removes a restriction that prevents the Department of Human Services from changing how pharmaceutical benefits are managed in Medicaid plans.

What This Bill Does

Repeals a provision in Act 4, Special Session Laws of Hawaii 2005, which prohibited the Department of Human Services from taking any action to remove pharmaceutical benefits management from managed care plans that provide health care coverage for Hawaii Medicaid beneficiaries.

Who It Names or Affects

People who receive Medicaid in Hawaii
Health care providers that work with the Medicaid program

Terms To Know

Medicaid: A government health insurance program for low-income people and those with disabilities.
Pharmaceutical Benefits Management (PBM): The process of managing how drugs are paid for in a health care plan.

Limits and Unknowns

Does not specify the exact date when this rule will be removed, but it is set to take effect on July 1, 3000.
It does not provide details about what new methods of managing pharmaceutical benefits might look like or how they would work.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

HD1

Hawaii published version HD1

Plain English: This amendment removes a restriction that prevents the Department of Human Services from changing pharmaceutical benefits management in Medicaid managed care plans.

Removes a provision that stops the Department of Human Services from taking actions to remove pharmaceutical benefits management from managed care plans for Medicaid beneficiaries.

The amendment does not specify what new actions the department can take regarding pharmaceutical benefit management, only that it is no longer restricted by this specific rule.
It's unclear how soon after July 1, 3000, the Department of Human Services will implement changes due to the very distant effective date.

Bill History

2026-02-18 H
Passed Second Reading as amended in HD 1 and referred to the committee(s) on FIN with none voting aye with reservations; none voting no (0) and none excused (0).
2026-02-18 H
Reported from HSH (Stand. Com. Rep. No. 376-26) as amended in HD 1, recommending passage on Second Reading and referral to FIN.
2026-02-12 H
The committee on HSH recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 8 Ayes: Representative(s) Marten, Olds, Amato, Hartsfield, Keohokapu-Lee Loy, Takayama, Alcos, Garcia; Ayes with reservations: none; Noes: none; and 1 Excused: Representative(s) Takenouchi.
2026-02-10 H
Bill scheduled to be heard by HSH on Thursday, 02-12-26 10:30AM in House conference room 329 VIA VIDEOCONFERENCE.
2026-01-30 H
Referred to HSH, FIN, referral sheet 5
2026-01-28 H
Introduced and Pass First Reading.
2026-01-26 H
Pending introduction.

Official Summary Text

RELATING TO MEDICAID.
Department of Human Services; Medicaid; Pharmaceutical Benefits Management; Managed Care Plans
Repeals a provision in Act 4, Special Session Laws of Hawaii 2005, that prohibits the Department of Human Services from taking any action to remove pharmaceutical benefits management from managed care plans that provide health care coverage for Hawaii Medicaid beneficiaries. Effective 7/1/3000. (HD1)

Current Bill Text

Read the full stored bill text

HB2224

HOUSE OF REPRESENTATIVES

H.B. NO.

2224

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

relating
to medicaid
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

����
SECTION 1.
�
The legislature finds that the State's medicaid
program, known as med-QUEST, serves some of Hawaii's most vulnerable residents,
including low-income families, kupuna, individuals with disabilities, and those
living in rural and neighbor island communities.
�
The legislature further finds that decisions
regarding pharmaceutical benefit management can significantly impact pharmacy
reimbursement, patience access, and overall healthcare expenditure.
�
Accordingly, it is in the State's best
interest to ensure that the department of human services retains the
flexibility necessary to evaluate and implement pharmaceutical benefit
management structures that best serve medicaid beneficiaries and participating
providers.

����
The legislature further finds that
existing limitations on the department's authority constrain the State's
ability to modernize medicaid program administration and adapt to evolving
health care delivery and pharmaceutical market conditions.
�
These constraints hinder the department's
ability to consider emerging models that are being adopted and evaluated at
both the federal and state levels.

����
The purpose of this Act is to
restore the department of human services' authority to assess and implement the
most effective pharmaceutical benefits management approach for med-QUEST and
ensure responsible stewardship of public funds.

����
SECTION 2.
�
Act 4, Special Session Laws of Hawaii 2005, is
amended by amending section 3 to read as follows:

����
"SECTION 3.
�
[
The department of human services shall
not take any action to remove pharmaceutical benefits management from managed
care plans that provide health care coverage for Hawaii medicaid beneficiaries.
]

Repealed.
"

����
SECTION 3.
�
Statutory material to be repealed is
bracketed and stricken.
�
New statutory
material is underscored.

����
SECTION 4.
�
This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

Department
of Human Services; Medicaid; Pharmaceutical Benefits Management; Managed Care
Plans

Description:

Repeals a
provision in Act 4, Special Session Laws of Hawaii 2005, that prohibits the
Department of Human Services from taking any action to remove pharmaceutical
benefits management from managed care plans that provide health care coverage
for Hawaii Medicaid beneficiaries.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.