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HB2507
HOUSE OF REPRESENTATIVES
H.B. NO.
2507
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII
A BILL FOR AN ACT
RELATING
TO HEALTH INSURANCE
.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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SECTION 1.
�
The
legislature finds that type two diabetes is a significant driver of preventable
health care costs in the State, particularly in rural, neighbor island, and
medically underserved communities where access to consistent outpatient
management and specialty care is limited.
�
Poorly controlled diabetes contributes to avoidable emergency department
visits, hospitalizations, and long-term complications that place substantial
strain on public and private health care systems.
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The legislature further finds that
continuous glucose monitors (CGMs) are an evidence-based diabetes management
technology that provide real-time glucose data, supports earlier clinical
intervention, and improves glycemic control.
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The use of CGMs has been shown to reduce hypoglycemic events and
high-cost acute care utilization, making CGMs an effective tool for improving
health outcomes while mitigating downstream health care expenditures.
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The legislature also finds that
inconsistent insurance coverage for CGMs creates inefficiencies in care
delivery and increases the likelihood of higher-cost interventions.
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Standardizing coverage across health plans,
including medicaid managed care programs, promotes predictable benefits,
reduces administrative burden, and supports uniform clinical practice.
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Accordingly, the purpose of this Act is to
require
all health insurers in the State, including medicaid managed care programs, to
cover the cost of continuous glucose monitors.
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SECTION
2
.
�
Section 431:10A-121, Hawaii Revised Statutes,
is amended to read as follows:
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"
�431:10A-121
�
Coverage for
diabetes.
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[
Each
]
(a)
�
Except as provided in subsection (b), each
policy of accident
and health or sickness insurance providing coverage for health care, other than
an accident-only, specified disease, hospital indemnity, medicare supplement,
long-term care, or other limited benefit health insurance policy, that is issued
or renewed in [
this
]
the
State, shall provide coverage for
outpatient diabetes self-management training, education, equipment, and
supplies, if:
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(1)
�
The
equipment, supplies, training, and education are medically necessary; and
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(2)
�
The
equipment, supplies, training, and education are prescribed by a health care
professional authorized to prescribe.
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(b)
�
Each individual
or
group accident and health or
sickness
policy, contract, plan, or agreement
issued or renewed in th
e
State after December 31, 2026,
shall provide coverage for
the cost of
continuous glucose monitors and related supplies
for
individuals covered under the policy, contract, plan, or agreement and
diagnosed with diabetes, including gestational diabetes, regardless of whether
they are treated with insulin; provided that:
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(1)
�
The continuous glucose
monitors
are
medically
necessary and
prescribed
by a health care professional authorized to prescribe
the
device; and
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(2)
�
The coverage:
���������
(A)
�
Shall
i
nclude
the cost of any necessary repairs or replacement parts for the continuous
glucose
monitor;
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(B)
�
Shall
be subject to a minimum benefit of
$ every
months; and
���������
(C)
�
May
be subject to copayment, deductible, and coinsurance provisions of the policy,
contract, plan, or agreement that are no less favorable than the copayment,
deductible, and coinsurance provisions for other medical services, equipment,
or supplies covered by the policy, contract, plan, or agreement;
provided further that this subsection shall not apply
to limited benefit health insurance as provided in section 43l:10A�607.
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For the purposes of this subsection,
"c
ontinuous
glucose monitor" means a device designed to aid in diabetes management by
continuously measuring glucose levels through a small electronic sensor applied
to the skin
that
remains in place for a minimum of seven days, transmitting
glucose data in real-time or at set intervals to monitor and maintain safe
blood glucose levels.
"
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SECTION
3
.
�
Section 432:1-612, Hawaii Revised Statutes,
is amended to read as follows:
����
"
[
[
]
�432:1-612
[
]
]
�
Diabetes coverage.
�
[
All
]
(a)
�
Except as provided in subsection (b), all
group health care
contracts under this chapter shall provide, to the extent provided under
section 431:10A-121, coverage for outpatient diabetes self-management training,
education, equipment, and supplies.
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(b)
�
Each hospital or medical service plan contract
issued or renewed in th
e
State after December 31, 2026,
shall provide coverage for
the cost of
continuous glucose monitors and related supplies
to the extent provided under
section 431:10A-121
.
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For the purposes of this subsection,
"c
ontinuous
glucose monitor"
has the same meaning as defined in section
431:10A‑121
.
"
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SECTION
4.
�
The benefit to be provided by health
maintenance organizations corresponding to the benefit provided under section
431:10A-
121
, Hawaii Revised Statutes, as amended in section 2 of
this Act, as contained in section 432D-23, Hawaii Revised Statutes, shall take
effect for all policies, contracts, plans, or agreements issued or renewed in
the State after December 31, 2026.
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SECTION 5.
�
The coverage required under sections 2, 3, and 4 of this Act shall apply
to all plans under medicaid managed care programs in the State.
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SECTION 6.
�
(a)
�
The department of human
services shall seek federal authorization and waivers as necessary to implement
this Act and to allow for full alignment with federal standards and
optimization of medicaid resources.
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(b)
�
The department of health and department of human services may accept and
expend funds from gifts, grants, and donations from individuals, private
organizations, foundations, or other governmental agencies to support the
expansion of continuous glucose monitor access; provided that no gift, grant,
or donation may be accepted if subject to conditions inconsistent with the laws
of this State.
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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 sections 2, 3,
and 4 shall apply to all policies, contracts, plans, or agreements issued or
renewed in the State after December 31, 2026; provided further that section 6
shall take effect upon approval of the Hawaii medicaid state plan by the
federal Centers for Medicare and Medicaid Services.
INTRODUCED BY:
_____________________________
Report Title:
Department
of Human Services; Department of Health; Health Insurance; Medicaid; Mandated
Coverage; Diabetes; Equipment and Supplies; Continuous Glucose Monitors
Description:
Requires
all health insurers in the State, including Medicaid managed care programs, to
cover the cost of continuous glucose monitors and related supplies under
certain conditions.
�
Applies to insurance
policies, contracts, plans, or agreements issued or renewed in the State after
12/31/2026.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.