§432:1-616 Cancer treatment. (a) All individual and group hospital and medical service plan contracts that include coverage or benefits for the treatment of cancer shall provide payment or reimbursement for all types of chemotherapy that are considered medically necessary as defined in section 432E-1.4.
(b) The cost-sharing for generic and non-generic oral chemotherapy shall be provided at the same or lower amount or percentage as is applied to generic and non-generic intravenously administered chemotherapy; provided that an insurer shall not increase the cost-share for intravenously administered chemotherapy in order to achieve compliance with this subsection.
(c) Individual and group hospital and medical service plan contracts shall not increase enrollee cost-sharing for non-generic medications used for the treatment of cancer to any greater extent than such policies increase enrollee cost-sharing for other covered non-generic medication.
(d) For the purposes of this section:
"Cost-share" or "cost-sharing" means copayment, coinsurance, or deductible provisions applicable to coverage for medications or treatments.
"Intravenously administered chemotherapy" means a physician-prescribed cancer treatment that is administered through injection directly into the patient's circulatory system by a physician, physician assistant, nurse practitioner, nurse, or other medical personnel under the supervision of a physician and in a hospital, medical office, or other clinical setting.
"Oral chemotherapy" means a United States Food and Drug Administration-approved, physician-prescribed cancer treatment that is taken orally in the form of a tablet or capsule and may be administered in a hospital, medical office, or other clinical setting or may be delivered to the patient for self-administration under the direction or supervision of a physician outside of a hospital, medical office, or other clinical setting.
(e) This section shall not apply to an accident-only, specified disease, hospital indemnity, long-term care, or other limited-benefit health insurance policy. [L 2009, c 168, §2; am L 2012, c 30, §2]
Structure Hawaii Revised Statutes
432:1-101.5 Disclosure of health care coverage and benefits.
432:1-101.6 Policies relating to domestic abuse cases.
432:1-102 Applicability of other laws.
432:1-103 Applicability of this article to existing societies and union mutual benefit societies.
432:1-104.5 Bona fide trade associations.
432:1-107 Federal law compliance.
432:1-201 Incorporation by charter.
432:1-202 Constitution and bylaws; officers; government of society.
432:1-203 Actions or proceedings.
432:1-301 Registration with commissioner: certificate of registration and certificate of authority.
432:1-302 Commissioner refusal to authorize certificate or solicitation; appeal to circuit court.
432:1-303 Authority to offer death, sick, disability, or other benefits; conditions.
432:1-306 Authority to offer death, sick, disability, or other benefits; deposit or bond.
432:1-308 Suspension, revocation, or denial of certificate of authority.
432:1-402 Investments of certain mutual benefit societies.
432:1-403 Nonprofit medical, hospital indemnity associations; tax exemption.
432:1-407 Protection against insolvency.
432:1-408 Uncovered expenditures insolvency deposit.
432:1-409 Rehabilitation, liquidation, or conservation of mutual benefit societies.
432:1-410 Reserve credit for reinsurance.
432:1-501 Examination by commissioner, assistance of other officers.
432:1-502 Summary orders and supervision.
432:1-503 Closing of doors without notice.
432:1-601 Contract limitations for handicapped children and children with intellectual disabilities.
432:1-601.5 Coverage for telehealth.
432:1-602 Newborn children coverage.
432:1-602.6 Newborn adoptee; coverage.
432:1-603 Reimbursement for psychological services.
432:1-604 In vitro fertilization procedure coverage.
432:1-604.5 Contraceptive services.
432:1-605 Mammogram screening.
432:1-605.5 Mammograms; referral not required.
432:1-606 Qualified medical child support order.
432:1-607 Genetic information nondiscrimination in health insurance coverage.
432:1-608 Hospice care coverage.
432:1-610 Federally funded programs; exemption.
432:1-613 Orthodontic services for orofacial anomalies; benefits and coverage; notice.
432:1-614 Autism benefits and coverage; notice; definitions.
432:1-615 Primary care provider; advanced practice registered nurse.
432:1-617 Colon cancer screening coverage.
432:1-618 Human immunodeficiency virus and acquired immunodeficiency syndrome screening coverage.
432:1-620 Formulary; accessibility requirements.
432:1-621 Medication synchronization; proration; dispensing fees.
432:1-622 Extension of dependent coverage.
432:1-623 Prohibition of preexisting condition exclusions.
432:1-624 Prohibited discrimination in premiums or contributions.
432:1-625 Reimbursement to providers.
432:2-102 Applicability of other laws.
432:2-103.5 Policies relating to domestic abuse cases.
432:2-104 Fraternal benefit societies.
432:2-106 Representative form of government.
432:2-107 Purposes and powers.
432:2-201 Qualifications for membership.
432:2-202 Location of office, meetings, communications to members, grievance procedures.
432:2-203 No personal liability.
432:2-305 Consolidations and mergers.
432:2-306 Conversion of fraternal benefit society into mutual life insurance company.
432:2-403 Benefits not attachable.
432:2-404 The benefit contract.
432:2-404.5 Genetic information nondiscrimination in health insurance coverage.
432:2-405 Nonforfeiture benefits, cash surrender values, certificate loans and other options.
432:2-406 Mammogram coverage required; referral not required.
432:2-410 Primary care provider; advanced practice registered nurse.
432:2-604 Examination of societies; no adverse publications.
432:2-605 Foreign or alien society, admission.
432:2-606 Injunction, liquidation, receivership of domestic society.
432:2-607 Suspension, revocation or refusal of license of foreign or alien society.
432:2-609 Licensing of producers.
432:2-610 Unfair methods of competition and unfair and deceptive acts and practices.
432:2-611 Federal law compliance.