RELATING TO PREVENTIVE MEDICINE.

SB3133

THE SENATE

S.B. NO.

3133

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

RELATING
TO PREVENTIVE MEDICINE
.

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

����
SECTION 1.
�

The legislature finds that access to preventive medicine, including
evidence-based clinical preventive services, is fundamental to maintaining and
improving the health of the people of Hawaii.
�

These essential preventive benefits and protections are increasingly
placed in jeopardy due to unwarranted skepticism towards long-established and
scientifically validated medical recommendations.

����
The legislature further finds that clinical
preventive services recommended by the Advisory Committee on Immunization
Practices and by the United States Preventive Services Task Force, such as
immunizations and other evidence-based preventive interventions, are currently
required to be covered by health insurance without cost-sharing under the
federal Patient Protection and Affordable Care Act.
�
However, if these recommendations are
withdrawn, invalidated, or otherwise no longer recognized under federal law,
these preventive medical services may cease to be covered without cost-sharing.

����
The loss of no-cost access to these
preventive services would likely increase out-of-pocket health care expenses
for Hawaii residents, causing many individuals to delay or forego preventive
care.
�
Such delays would increase the
risk of infectious disease outbreaks and contribute to the growing burden of
chronic disease across the State.

����
Accordingly, the purpose of this Act is to
ensure continued access to preventive medicine by requiring coverage of
evidence-based clinical preventive services without cost-sharing for the people
of Hawaii.

����
SECTION 2.
�

Chapter 321, Hawaii Revised Statutes, is amended by adding to part II
three new sections to be appropriately designated and to read as follows:

����
"
�321-A
�
Hawaii preventive
services
advisory committee; established.
�
(a)
�

There is established within the department of health the Hawaii
preventive services advisory committee, which shall serve in an advisory
capacity to the department of health on matters relating to clinical preventive
services.

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(b)
�

The Hawaii preventive services advisory committee shall be composed of
ten members.
�
The director of health or
the director's designee shall serve as an ex officio nonvoting chair of the
advisory committee and invite one representative from each of the following
organizations to serve as the advisory committee members:

����
(1)
�
Hawaii
chapter of the American Academy of Pediatrics;

����
(2)
�
Hawaii
chapter of the American Academy of Family Physicians;

����
(3)
�
Hawaii
chapter of the American Academy of Obstetricians and Gynecologists;

����
(4)
�
Hawaii
chapter of the American College of Physicians;

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(5)
�
Hawaii
Association of Professional Nurses;

����
(6)
�
Hawaii
Medical Association;

����
(7)
�
Hawaii
Association of Health Plans;

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(8)
�
Healthcare
Association of Hawaii; and

����
(9)
�
Hawaii
Primary Care Association, which may nominate a consumer representative
knowledgeable about consumer perspectives or community aspects of clinical
prevention.

����
(c)
�

The members of the Hawaii preventive services advisory committee shall
not be deemed officers or employees of the State; provided that the members
shall be subject to chapter 84.
�
Each
member shall serve for a term of up to four years, as determined by the
director of health; provided that no members shall serve more than eight
consecutive years.
�
The director of
health or the director's designee may designate staggered term lengths for
initial members, including terms of one, two, three, or four years.

����
(d)
�

There shall be no liability on the part of, and no cause of action of
any nature shall rise against, the Hawaii preventive services advisory
committee, the advisory committee members, or the department of health for any
act or omission done in good faith in the performance of their duties in the
exercise of their functions under this section, including development,
adoption, issuance, or implementation of clinical preventive service
recommendations; provided that this subsection shall not be construed to limit
or affect the liability of any person arising from the provision of direct
medical care.

����
(e)
�

The members of the Hawaii preventive services advisory committee shall
serve without compensation but shall be reimbursed for expenses, including
travel expenses, necessary for the performance of their duties.

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�321-B
�
Hawaii preventive services advisory
committee; scope; duties.
�
(a)
�
The scope of the Hawaii preventive services
advisory committee shall be limited to recommendations relating to clinical
preventive service recommendations of the United States Preventive Services
Task Force that have been assigned a grade of A or B as of July 1, 2025, and to
recommendations relating to immunizations.

����
(b)
�

The Hawaii preventive services advisory committee shall base its
recommendations on the best available scientific evidence and shall give due
consideration to recommendations issued by recognized national medical
professional organizations.

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(c)
�

The Hawaii preventive services advisory committee shall make its
recommendations independently of any recommendations developed through, or in
coordination with, any multi-state alliance or agreement made for the purpose
of issuing clinical prevention service recommendations.

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(d)
�

The department of health shall consider recommendations submitted by the
Hawaii preventive services advisory committee when issuing clinical preventive
service recommendations pursuant to section 321-31.

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�321-C
�
Preventive services; immunity.
�
(a)
�

No person shall be subject to civil or criminal liability or
professional disciplinary action or deemed to have engaged in unprofessional
conduct for providing clinical preventive services in accordance with recommendations
made pursuant to section 321-31.

����
(b)
�

No professional organization or association, health care provider, or
health care facility shall subject any person to discipline, suspension, loss
of license, loss of privileges, loss of membership, or other penalty for
providing clinical preventive services in accordance with recommendations made
pursuant to section 321-31.

����
(c)
�

Nothing in this section shall be construed to limit, restrict, or
prohibit any claim, cause of action, or right of recovery against any person or
entity for injury arising from negligence.
"

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SECTION 3.
�

Chapter 431, Hawaii Revised Statutes, is amended by adding to article
10A, part I, a new section to be appropriately designated and to read as
follows:

����
"
�431:10A-
��
��
Preventive
services coverage; department of health recommendations.
�
(a)
�

All health insurance policies delivered or issued for delivery in the
State shall provide coverage, without any deductible, copayment, coinsurance,
or other cost-sharing requirements, for clinical preventive services
recommended by the department of health pursuant to section 321-31.

����
(b)
�

Coverage under this section shall include items and services furnished
by a provider acting within the scope of the provider's license.

����
(c)
�

This section shall not be construed to limit any broader coverage or
benefits related to preventive services otherwise required under this chapter.

����
(d)
�

This section shall not apply to disability income, specified disease,
medicare supplement, or hospital indemnity policies.
"

����
SECTION 4.
�

Chapter 432, Hawaii Revised Statutes, is amended by adding to article 1,
part VI, a new section to be appropriately designated and to read as follows:

����
"
�432:1-
��
��
Preventive
services coverage; department of health recommendations.
�
(a)
�

All individual and group hospital and medical health service corporation
contracts delivered or issued for delivery in the State shall provide coverage,
without any deductible, copayment, coinsurance, or other cost-sharing
requirements, for clinical preventive services recommended by the department of
health pursuant to section 321-31.

����
(b)
�

Coverage under this section shall include items and services furnished
by a provider acting within the scope of the provider's license.

����
(c)
�

This section shall not be construed to limit any broader coverage or
benefits related to preventive services otherwise required under this chapter.

����
(d)
�

This section shall not apply to disability income, specified disease,
medicare supplement, or hospital indemnity policies.
"

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SECTION 5.
�

Section 321-31, Hawaii Revised Statutes, is amended to read as follows:

����
"
�321-31
�
Functions of the department.
�
The powers, duties, and functions of the
department of health relating to preventive medicine shall be as follows:

����
(1)
�
To
supervise and coordinate activities in the fields of preventive medicine,
including cancer control, crippled children, epidemiology, geriatrics,
laboratories, maternal and child health, mental hygiene, nutrition, and
communicable diseases;

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(2)
�
To
formulate and put into effect throughout the State educational programs for the
purposes of preventing and reducing disease and disability;

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(3)
�
To
engage in the collection and analysis of statistical information pertinent to
any of its activities;

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(4)
�
To
cooperate with and propose methods and programs to other governmental agencies
relating to the fields of preventive medicine;

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(5)
�
To
serve as the coordinating agency for programs [
which
]
that

provide for a range of child abuse and neglect prevention services in relation
to assessed needs, regardless of whether the programs are conducted by the
department, other government agencies, or private organizations and to
coordinate the prevention programs with child abuse and neglect treatment
services; provided that this paragraph shall not be interpreted to compel a
specified level of services; [
and
]

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(6)
�
To
make clinical preventive service recommendations based on the recommendations
of the Hawaii preventive services advisory committee established pursuant to
section 321-A, or pursuant to an alliance entered into with another state for
the purpose of issuing clinical preventive service recommendations;

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(7)
�
To
issue standing orders for medications and immunizations; and

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[
(6)
]

(8)
�
To perform such other appropriate functions
as may be required."

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SECTION 6.
�

Section 431:10A-115.5, Hawaii Revised Statutes, is amended by amending
subsections (b) and (c) to read as follows:

����
"(b)
�

Child health supervision services shall include twelve visits at
approximately the following intervals:
�

birth; two months; four months; six months; nine months; twelve months;
fifteen months; eighteen months; two years; three years; four years; and five
years.
�
Services to be covered at each
visit shall include a history, physical examination, developmental assessment,
anticipatory guidance, immunizations, and laboratory tests, in keeping with
prevailing medical standards.
�
For
purposes of this subsection, the term "prevailing medical standards"
means the recommendations of the Advisory Committee on Immunization Practices
of the United States Department of Health and Human Services and the American
Academy of Pediatrics[
;
]
, or the recommendations of the department of
health made pursuant to section 321-31;
provided that if [
the
]
these

recommendations [
of the committee and the academy
] differ, the
department of health shall determine which recommendations shall apply.

����
(c)
�

Minimum benefits may be limited to one visit payable to one provider for
all of the services provided at each visit cited in this section, except that
the limitations authorized by this subsection shall not apply to immunizations
recommended by the Advisory Committee on Immunization Practices of the United
States Department of Health and Human Services and the American Academy of
Pediatrics[
;
]
, or the recommendations of the department of health
made pursuant to section 321-31;
provided that if [
the
]
these

recommendations [
of the committee and the academy
] differ, the
department of health shall determine which recommendations shall apply."

����
SECTION 7.
�

Section 431:10A-206.5, Hawaii Revised Statutes, is amended by amending
subsections (b) and (c) to read as follows:

����
"(b)
�

Child health supervision services shall include twelve visits at
approximately the following intervals:
�

birth; two months; four months; six months; nine months; twelve months;
fifteen months; eighteen months; two years; three years; four years; and five
years.
�
Services to be covered at each
visit shall include a history, physical examination, developmental assessment,
anticipatory guidance, immunizations, and laboratory tests, in keeping with
prevailing medical standards.
�
For
purposes of this subsection, the term "prevailing medical standards"
means the recommendations of the Advisory Committee on Immunization Practices
of the United States Department of Health and Human Services and the American
Academy of Pediatrics[
;
]
, or the recommendations of the department of
health made pursuant to section 321-31;
provided that if [
the
]
these

recommendations [
of the committee and the academy
] differ, the
department of health shall determine which recommendations shall apply.

����
(c)
�

Minimum benefits may be limited to one visit payable to one provider for
all of the services provided at each visit cited in this section, except that
the limitations authorized by this subsection shall not apply to immunizations
recommended by the Advisory Committee on Immunization Practices of the United
States Department of Health and Human Services and the American Academy of
Pediatrics[
;
]
, or the recommendations of the department of health
made pursuant to section 321-31;
provided that if [
the
]
these

recommendations [
of the committee and the academy
] differ, the
department of health shall determine which recommendations shall apply."

����
SECTION 8.
�

Section 431:10A-207, Hawaii Revised Statutes, is amended to read as
follows:

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"
�431:10A-207
�
Coverage for specific services.
�
Every person insured under a group or blanket
disability insurance policy shall be entitled to the reimbursements and
coverages specified in [
section
]
sections
431:10A-116[
.
]
and
431:10A-
��
.
"

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SECTION 9.
�

Section 431:26-103, Hawaii Revised Statutes, is amended by amending
subsection (a) to read as follows:

����
"(a)
�

Network adequacy requirements shall be as follows:

����
(1)
�
A
health carrier providing a network plan shall maintain a network that is
sufficient in numbers and appropriate types of providers, including those that
serve predominantly low-income, medically underserved individuals, to assure
that all covered benefits will be accessible without unreasonable travel or
delay; [
and
]

����
(2)
�
Covered
persons shall have access to emergency services twenty-four hours per day,
seven days per week[
.
]
; and

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(3)
�
The
network shall include an adequate number and geographic distribution of
providers authorized to furnish clinical preventive services for which coverage
is required under state law or rule, including services recommended by the
department of health pursuant to section 321-31, to ensure timely access to
those services without unreasonable travel or delay.
"

����
SECTION 10.
�

Section 432:1-602.5, Hawaii Revised Statutes, is amended by amending
subsections (b) and (c) to read as follows:

����
"(b)
�

Child health supervision services shall include twelve visits at
approximately the following intervals:
�

birth; two months; four months; six months; nine months; twelve months;
fifteen months; eighteen months; two years; three years; four years; and five
years.
�
Services to be covered at each
visit shall include a history, physical examination, developmental assessment,
anticipatory guidance, immunizations, and laboratory tests, in keeping with
prevailing medical standards.
�
For
purposes of this subsection, the term "prevailing medical standards"
means the recommendations of the Advisory Committee on Immunization Practices
of the United States Department of Health and Human Services and the American
Academy of Pediatrics[
;
]
, or the recommendations of the department of
health made pursuant to section 321-31;
provided that if [
the
]
these

recommendations [
of the committee and the academy
] differ, the
department of health shall determine which recommendations shall apply.

����
(c)
�

Minimum benefits may be limited to one visit payable to one provider for
all of the services provided at each visit cited in this section, except that
the limitations authorized by this subsection shall not apply to immunizations
recommended by the Advisory Committee on Immunization Practices of the United
States Department of Health and Human Services and the American Academy of
Pediatrics[
;
]
, or the recommendations of the department of health
made pursuant to section 321-31;
provided that if [
the
]
these

recommendations [
of the committee and the academy
] differ, the
department of health shall determine which recommendations shall apply."

����
SECTION 11.
�

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-
��
,

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-140, and 431:10A-134, and chapter 431M."

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SECTION 12.
�

Section 432E-1.4, Hawaii Revised Statutes, is amended by amending
subsection (a) to read as follows:

����
"(a)
�

For contractual purposes, a health intervention shall be covered if it
is an otherwise covered category of service, not specifically excluded,
recommended by the treating licensed health care provider, and determined by
the health plan's medical director to be medically necessary as defined in
subsection (b).
�
Notwithstanding any
determination under this section, coverage for any clinical preventive service
for which coverage is required under state law or rule, including clinical
preventive services recommended by the department of health pursuant to section
321-31, shall not be denied on the basis of medical necessity or subject to
prior authorization, except as permitted for reasonable medical management.
�
A health intervention may be medically
indicated and not qualify as a covered benefit or meet the definition of
medical necessity.
�
A managed care plan
may choose to cover health interventions that do not meet the definition of
medical necessity."

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SECTION 13.
�

Section 461-11.4, Hawaii Revised Statutes, is amended by amending its
title and subsection (a) to read as follows:

����
"
�461-11.4
�
Vaccinations[
; children
]
.
�
(a)
�
A
pharmacist, pharmacy intern, or pharmacy technician under the direct
supervision of a pharmacist may administer a vaccine to a person three years of
age or older; provided that:

����
(1)
�
The
vaccine is authorized or approved by the United States Food and Drug
Administration[
;
]
for any indication;

����
(2)
�
The
vaccine has been ordered by a pharmacist and administered in accordance with
the recommendations of the Advisory Committee on Immunization Practices of the
United States Department of Health and Human Services[
;
]
, or the
department of health pursuant to section 321-31;

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(3)
�
The
pharmacy intern has completed a practical training program approved by the
Accreditation Council for Pharmacy Education that includes hands-on injection
technique, clinical evaluation of indications and contraindications of
vaccines, and the recognition and treatment of emergency responses to vaccines;

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(4)
�
The
pharmacy technician has completed a practical training program approved by the
Accreditation Council for Pharmacy Education that includes hands-on injection
technique;

����
(5)
�
The
pharmacy technician has a Certified Pharmacy Technician certification from
either the Pharmacy Technician Certification Board or National Healthcareer
Association;

����
(6)
�
The
pharmacist, pharmacy intern, or pharmacy technician has a current certificate
in basic cardiopulmonary resuscitation;

����
(7)
�
The
pharmacist or pharmacy technician has completed a minimum of two credit hours
in immunization-related continuing education courses during each licensing
biennium;

����
(8)
�
The
pharmacist is in compliance with all applicable recordkeeping and reporting
requirements, including complying with adverse events reporting requirements;

����
(9)
�
The
pharmacist, pharmacy intern, or pharmacy technician has reviewed the patient's
vaccination records before administering the vaccine;

���
(10)
�
The
pharmacist has informed the patient and the patient's primary guardian or
caregiver of the importance of a well-child visit with a pediatrician or other
licensed primary care provider and has referred the patient as appropriate; and

���
(11)
�
Where
a prescription has been ordered by a person other than the pharmacist[
,
]

or a standing order pursuant to section 321-31,
the pharmacist, pharmacy
intern, or pharmacy technician shall verify that the prescriber or the
prescriber's authorized agent is the patient's medical home."

����
SECTION 14.
�

Notwithstanding section 23-51, Hawaii Revised Statutes, this Act shall
be exempt from the requirements for an impact assessment report on proposed
mandatory health insurance coverage.

����
SECTION 15.
�

The benefit to be provided by health maintenance organizations
corresponding to the benefit provided under sections 431:10A-
��
, Hawaii Revised Statutes, if any, as contained
in the amendment to section 432D-23, Hawaii Revised Statutes, in section 11 of
this Act, shall take effect for all policies, contracts, plans, or agreements
issued in the State after January 1, 2027.

����
SECTION 16.
�

Notwithstanding any other law to the contrary, the coverage for
evidence-based clinical preventive services required under sections 3, 4, 6, 7,
8, 10, 11, and 12 of this Act shall apply to all health benefits plans under
chapter 87A, Hawaii Revised Statutes.

����
SECTION 17.
�

This Act does not affect rights and duties that matured, penalties that
were incurred, and proceedings that were begun before its effective date.

����
SECTION 18.
�

In codifying the new sections added by section 2 and referenced in
section 5 of this Act, the revisor of statutes shall substitute appropriate
section numbers for the letters used in designating the new sections in this
Act.

����
SECTION 19.
�

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

����
SECTION 20.
�

This Act, upon its approval, shall take effect on July 1, 2026.

INTRODUCED BY:

_____________________________

BY REQUEST

Report Title:

DOH;
Hawaii Preventive Services Advisory Committee; Insurance Coverage; Cost-Share;
Standing Orders; Immunity; Sunrise Analysis Exemption

Description:

Establishes
the Hawaii Preventive Services Advisory Committee and authorizes the Department
of Health to issue preventive service recommendations.
�
Requires health insurance coverage without
cost-sharing for Department of Health-recommended clinical preventive
services.
�
Provides immunity for
healthcare providers' and facilities' provision of recommended clinical
preventive services.

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