HB1871

SECTION 1. Definitions. As used in this Act, unless the context clearly indicates otherwise:

"Department" means the department of health.

"Eligible participant" means a patient who is:

(1) A recipient of medical assistance;

(2) A member of a participating managed care organization; and

(3) Pregnant.

"Escalation pathway" means an agreement between the participating managed care organization and the technology vendor on a process to follow when an eligible participant's measurements are concerning and warrant further review and investigation.

"Health care provider" means an obstetrician or maternal-fetal medicine physician who:

(1) Is licensed in Hawaii;

(2) Is in-network with a participating managed care organization; and

(3) Cares for an eligible participant during pregnancy.

"Participating managed care organization" means a managed care organization selected by the department to administer the pilot program.

"Pilot program" means the maternal health monitoring pilot program.

"Remote monitoring clinical care team" means a team of nurses who are licensed in Hawaii and dietitians that monitor eligible participants' measurements and provide nutrition guidance, diabetes and hypertension condition management counseling, and pregnancy and postpartum advice.

"Remote patient monitoring for maternal hypertension and maternal diabetes" means technology provided by the technology vendor that:

(1) Collects health data from an eligible participant and electronically transmits that information securely for interpretation and recommendation;

(2) Uses devices that are authorized by the United States Food and Drug Administration;

(3) Monitors health data, including blood pressure, weight, blood glucose levels, or other physiological health data as determined by the eligible participant's health care provider;

(4) Transmits health data through cellular networks; and

(5) Provides preprogrammed equipment specifically for each eligible participant.

"Technology vendor" means the technology company selected by the department to contract with the participating managed care organizations in administering the pilot program.

SECTION 2. Maternal health monitoring pilot program; establishment; administration. (a) The maternal health monitoring pilot program shall be established within the department to offer eligible participants improved maternal health care through remote patient monitoring for maternal hypertension and maternal diabetes.

(b) The department shall implement the pilot program in as many counties as necessary to ensure participation of up to three hundred eligible participants.

(c) The department shall select one or more participating managed care organizations and one technology vendor to administer the pilot program in a manner determined by the department.

(d) The participating managed care organizations shall:

(1) Contract directly with the technology vendor to offer remote patient monitoring for maternal hypertension and maternal diabetes; and

(2) Ensure that eligible participants have access to the pilot program.

(e) The pilot program shall be operational no later than one hundred eighty days after the contract date between a participating managed care organization and the technology vendor; provided that the contract shall be executed no later than June 30, 2027.

(f) The pilot program shall conclude two years after the pilot program becomes operational.

SECTION 3. Remote patient monitoring for maternal hypertension and maternal diabetes; requirements. The technology vendor shall meet the following requirements when offering remote patient monitoring for maternal hypertension and maternal diabetes to an eligible participant under the pilot program:

(1) Ensure that remote patient monitoring for maternal hypertension and maternal diabetes is available during pregnancy and for up to three months postpartum;

(2) Ensure that remote patient monitoring devices are delivered to eligible participants;

(3) Ensure that eligible participants have access to a training process on how to use the remote patient monitoring devices;

(4) Assign a program manager to support implementation and administration of the pilot program and to coordinate efforts with the participating managed care organizations and department; and

(5) Employ a remote monitoring clinical care team that is capable of:

(A) Monitoring and reviewing an eligible participant's health data;

(B) Creating an escalation pathway with the participating managed care organization if an eligible participant's remote patient monitoring readings for maternal hypertension and maternal diabetes, in conjunction with the eligible participant's symptoms, require additional medical attention;

(C) Providing health coaching to eligible participants in matters including nutrition, condition management, and healthy behavior modification; and

(D) Coordinating with an eligible participant's health care provider as needed.

SECTION 4. Fee for administration of the maternal health monitoring pilot program. (a) The department shall pay a fee to the participating managed care organizations to administer the pilot program.

(b) The participating managed care organizations shall use the fee payment to cover the costs of:

(1) Contracting with the technology vendor; and

(2) Administering the pilot program.

SECTION 5. Report. (a) Twenty-four months after the pilot program's implementation, the department shall collaborate with the participating managed care organizations and any other relevant stakeholders to develop a report evaluating the outcomes of the pilot program. The report shall include recommendations regarding whether the pilot program should be expanded throughout the State.

(b) The report shall include data from pilot program participants, including claims data, vital statistics data, and electronic health record and electronic medical record data, to determine the pilot program's impact on the following maternal, fetal, and neonatal health outcomes and to assess whether the program improves maternal, fetal, and neonatal health and results in Medicaid savings:

(1) Maternal outcomes:

(A) Maternal mortality rate;

(B) Severe maternal morbidity rate;

(D) Cesarean section rate;

(E) Mean length of delivery hospital stay;

(F) Intensive care unit admission rate;

(G) Mean length of intensive care unit stay;

(H) Emergency department visits, hospitalizations, and postpartum hospital readmission rate; and

(I) Postpartum visit adherence rate; and

(2) Fetal and neonatal outcomes:

(A) Fetal mortality rate;

(B) Fetal growth restriction;

(D) Neonatal intensive care unit admission rate;

(E) Mean length of neonatal intensive care unit stay;

(F) Neonatal hypoglycemia;

(G) Preterm birth;

(H) Gestational age at delivery; and

(I) Birthweight.

(1) The governor;

(2) The president of the senate;

(3) The speaker of the house of representatives;

(4) The chair and vice chair of the senate committee on health and human services; and

(5) The chair and vice chair of the house of representatives committee on health.

SECTION 6. There is appropriated out of the general revenues of the State of Hawaii the sum of $600,000 or so much thereof as may be necessary for fiscal year 2026-2027 for the purpose of the pilot program established in this Act.

The sum appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 7. This Act shall take effect on July 1, 2026.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	1871
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII