H.B. 2194 Summary

• Prohibits health insurers from requiring step therapy for patients diagnosed with stage two through stage five cancer before covering FDA-approved drugs prescribed by their healthcare provider, effective for policies issued or renewed after December 31, 2024.

• Applies the step therapy prohibition to investigational new drugs and prescription drugs that are FDA-approved, consistent with best practices for the respective cancer stage, and listed on the insurer's formulary.

• Defines "step therapy" as a protocol requiring patients to use alternative prescription drugs before coverage of the healthcare provider's recommended drug.

• Extends the prohibition to individual and group accident and health policies, hospital and medical service plans, and health maintenance organization contracts issued or renewed in Hawaii after December 31, 2024.

• Establishes that "investigational new drug" has the same meaning as defined under 21 Code of Federal Regulations section 312.3.