SB3045 HD2

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.

The legislature further finds that continuous glucose monitors are an evidence-based diabetes management technology that provide real-time glucose data, supports earlier clinical intervention, and improves glycemic control. The use of continuous glucose monitors has been shown to reduce hypoglycemic events and high-cost acute care utilization, making continuous glucose monitors an effective tool for improving health outcomes while mitigating downstream health care expenditures.

The legislature also finds that inconsistent insurance coverage for continuous glucose monitors creates inefficiencies in care delivery and increases the likelihood of higher-cost interventions. Standardizing coverage across health plans, including medicaid managed care programs, promotes predictable benefits, reduces administrative burdens, and supports uniform clinical practice.

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.

SECTION 2. Section 431:10A-121, Hawaii Revised Statutes, is amended to read as follows:

"§431:10A-121 Coverage for diabetes. [~~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 State, shall provide coverage for outpatient diabetes self-management training, education, equipment, and supplies, if:

(1) The equipment, supplies, training, and education are medically necessary; and

(2) The equipment, supplies, training, and education are prescribed by a health care professional authorized to prescribe.

(b) Each individual or group policy of accident and health or sickness insurance issued or renewed in the State after December 31, 2026, shall provide coverage for the cost of continuous glucose monitors and related supplies for individuals covered under the policy and diagnosed with diabetes, including gestational diabetes, regardless of whether they are treated with insulin; provided that:

(1) The continuous glucose monitors are medically necessary and prescribed by a health care professional authorized to prescribe the device; and

(2) The coverage:

(A) Shall include the cost of any necessary repairs or replacement parts for the continuous glucose monitor; and

(B) May be subject to copayment, deductible, and coinsurance provisions of the policy that are no less favorable than the copayment, deductible, and coinsurance provisions for other medical services, equipment, or supplies covered by the policy;

provided further that this subsection shall not apply to limited benefit health insurance as provided in section 43l:10A—607.

For the purposes of this subsection, "continuous 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."

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~~] hospital or medical service plan 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.

(b) Each hospital or medical service plan contract issued or renewed in the State after December 31, 2026, shall provide coverage for the cost of continuous glucose monitors and related supplies for individuals covered under the plan contract and diagnosed with diabetes, including gestational diabetes, regardless of whether they are treated with insulin; provided that:

(1) The continuous glucose monitors are medically necessary and prescribed by a health care professional authorized to prescribe the device; and

(2) The coverage:

(A) Shall include the cost of any necessary repairs or replacement parts for the continuous glucose monitor; and

(B) May be subject to copayment, deductible, and coinsurance provisions of the plan contract that are no less favorable than the copayment, deductible, and coinsurance provisions for other medical services, equipment, or supplies covered by the plan contract.

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 by 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.

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.

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.

(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.

SECTION 7. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 8. This Act shall take effect on July 1, 3000; provided that section 5 shall take effect upon approval of the Hawaii medicaid state plan by the federal Centers for Medicare and Medicaid Services.

THE SENATE	S.B. NO.	3045
THIRTY-THIRD LEGISLATURE, 2026		S.D. 1
STATE OF HAWAII		H.D. 2