Read the full stored bill text
SB2855
THE SENATE
S.B. NO.
2855
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII
A BILL FOR AN ACT
relating
to opioid antagonists
.
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-
�
Opioid antagonists; coverage.
�
(a)
�
Each individual or group policy of accident
and health or sickness insurance that provides prescription drug coverage issued
or renewed in the State on or after January 1, 2027, shall provide coverage for
the policyholder, or any dependent of the policyholder who is covered by the
policy, for at least one generic opioid antagonist and device.
����
(b)
�
Generic opioid antagonists and devices covered by this section:
����
(1)
�
Shall be placed
on the lowest cost-sharing tier of the formulary managed by the health insurer
or pharmacy benefits manager;
����
(2)
�
Shall not be
subject to any annual or lifetime dollar limitations;
����
(3)
�
Shall not be subject
to financial requirements and quantitative treatment limitations that do not
comply with the Mental Health Parity and Addiction Equity Act of 2008, P.L.
110-343; and
����
(4)
�
Shall not
require prior authorization, except that prior authorization may be required
for the
prescription of non-generic
forms of opioid antagonists and devices.
����
(c)
�
For the purposes of this section:
����
"Device"
means an administration mechanism that delivers an opioid antagonist
medication, including but not limited to prepackaged nasal spray, oral tablets,
and auto-injectors.
����
"Formulary" has the same meaning as
in section 431:10A-140.
����
"Opioid antagonist" means naloxone
hydrochloride and any other drug approved by the United States Food and Drug
Administration for the treatment of opioid overdose.
����
"Pharmacy benefit manager" has the
same meaning as in section 431R-1.
"
����
SECTION 2.
�
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-
�
Opioid antagonists; coverage.
�
(a)
�
Each individual or group hospital or medical
service plan contract that provides prescription drug coverage issued or
renewed in the State on or after January 1, 2027, shall provide coverage for
the subscriber or member, or any dependent of the subscriber or member who is
covered by the plan contract, for at least one generic opioid antagonist and
device.
����
(b)
�
Generic opioid antagonists and devices covered by this section:
����
(1)
�
Shall be placed
on the lowest cost-sharing tier of the formulary managed by the mutual benefit
society or pharmacy benefits manager;
����
(2)
�
Shall not be
subject to any annual or lifetime dollar limitations;
����
(3)
�
Shall not be
subject to financial requirements and quantitative treatment limitations that
do not comply with the Mental Health Parity and Addiction Equity Act of 2008,
P.L. 110-343; and
����
(4)
�
Shall not
require prior authorization, except that prior authorization may be required
for the
prescription of non-generic
forms of opioid antagonists and devices.
����
(c)
�
For the purposes of this section:
����
"Device"
means an administration mechanism that delivers an opioid antagonist
medication, including but not limited to prepackaged nasal spray, oral tablets,
and auto-injectors.
����
"Formulary" has the same meaning as
in section 432:1-620.
����
"Opioid antagonist" means naloxone
hydrochloride and any other drug approved by the United States Food and Drug
Administration for the treatment of opioid overdose.
����
"Pharmacy benefit manager" has the
same meaning as in section 431R-1.
"
����
SECTION 3.
�
Chapter 432D, Hawaii Revised Statutes, is
amended by adding a new section to be appropriately designated and to read as
follows:
����
"
�432D-
�
Opioid
antagonists; coverage.
�
(a)
�
Each
health maintenance organization policy, contract, plan, or agreement issued or
renewed in the State on or after January 1, 2027, shall provide coverage for the
subscriber or enrollee, or any dependent of the subscriber or enrollee who is
covered by the policy, contract, plan, or agreement, for at least one generic
opioid antagonist and device.
����
(b)
�
Generic opioid antagonists and devices covered by this section:
����
(1)
�
Shall be placed
on the lowest cost-sharing tier of the formulary managed by the health
maintenance organization or pharmacy benefits manager;
����
(2)
�
Shall not be
subject to any annual or lifetime dollar limitations;
����
(3)
�
Shall not be
subject to financial requirements and quantitative treatment limitations that
do not comply with the Mental Health Parity and Addiction Equity Act of 2008,
P.L. 110-343; and
����
(4)
�
Shall not
require prior authorization, except that prior authorization may be required
for the
prescription of non-generic
forms of opioid antagonists and devices.
����
(c)
�
For the purposes of this section:
����
"Device"
means an administration mechanism that delivers an opioid antagonist
medication, including but not limited to prepackaged nasal spray, oral tablets,
and auto-injectors.
����
"Formulary" has the same meaning as
in section 431:10A-140.
����
"Opioid antagonist" means naloxone
hydrochloride and any other drug approved by the United States Food and Drug
Administration for the treatment of opioid overdose.
����
"Pharmacy benefit manager" has the
same meaning as in section 431R-1.
"
����
SECTION 5.
�
New statutory material is underscored.
����
SECTION 6.
�
This Act shall take effect upon its approval.
INTRODUCED BY:
_____________________________
Report Title:
Health
Insurance; Health Insurers; Mutual Benefit Societies; Health Maintenance
Organizations; Prescription Drug Coverage; Opioid Antagonists
Description:
Beginning
1/1/2027, requires health insurers, mutual benefit societies, and health
maintenance organizations that issue policies, contracts, plans, or agreements
that provide prescription drug coverage to provide coverage for at least one
generic opioid antagonist and device.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.