SB 2281 Hawaii Senate · 2026 Regular Session

RELATING TO THE USE OF ARTIFICIAL INTELLIGENCE IN HEALTH CARE.

Summary

Requires health care providers using artificial intelligence (AI) in patient interactions to disclose to the patient that the patient is interacting with artificial intelligence. Requires health care providers using AI in making consequential decisions relating to the patient to provide certain notice and statements to the patient; maintain a qualified AI oversight personnel who shall be a natural person that reviews, evaluates, and validates or overrides AI outputs; monitor and conduct regular performance evaluations of their AI systems; implement procedures to address identified deficiencies; and maintain certain records. Requires the Department of Health to adopt rules. Implementation effective 7/1/2028. Effective 1/30/2050. (SD1)

Issues: ✓ Healthcare ✓ Technology

Bill status passed 3 of 5 stages cleared

Introduction

Jan 2026

Committee Review

Feb 2026

Senate Passage

Feb 2026

House Passage

Governor

Introduced Jan 15, 2026 Last action Feb 18, 2026

Maddy AI version diff · 1 comparison

What changed between versions

SB2281 → SB2281_SD1 · 4 edits

MODERATE

This bill was converted from a House bill to a Senate bill, updating metadata and formatting. The core policy regarding artificial intelligence in healthcare remains largely the same, but the effective dates were significantly altered to delay implementation until 2028, with the full act taking effect in 2050. Minor wording adjustments were made to definitions and procedural requirements for patient notifications.

Scope change

The scope of the bill's applicability remains unchanged; it still applies to health care providers using AI systems for patient interaction or consequential decisions.

TIMELINE

The effective date for the entire act was changed from immediate approval to January 30, 2050, while the specific operational requirements were delayed until July 1, 2028.

DEFINITION

The definition of 'Consequential decision' was narrowed to focus only on effects on physical or mental health, removing the previous language regarding legal effects or costs of care.

REQUIREMENT

Wording was slightly adjusted in several sections to clarify that terms like 'health care service' and 'health information' are defined in other statutes, rather than being defined within this bill.

TECHNICAL

The bill was renumbered and reformatted from an HB template to an SD (Senate) template, including updates to author names and legislative session details.

Floor votes

How they voted

This bill passed the Senate by voice vote (no roll call recorded).

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Feb 18, 2026

Upper · Passed

Report adopted; Passed Second Reading, as amended (SD 1) and referred to CPN/WAM.

upper

Feb 18, 2026

Committee

Reported from HHS/LBT (Stand. Com. Rep. No. 2357) with recommendation of passage on Second Reading, as amended (SD 1) and referral to CPN/WAM.

upper

Feb 4, 2026

Upper · Passed

The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in HHS were as follows: 5 Aye(s): Senator(s) San Buenaventura, Kanuha, Keohokalole, Fevella; Aye(s) with reservations: Senator(s) McKelvey ; 0 No(es): none; and 0 Excused: none.

upper

Feb 4, 2026

Upper · Passed

The committee(s) on LBT recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in LBT were as follows: 4 Aye(s): Senator(s) Elefante, Lamosao, Moriwaki, Fevella; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Ihara.

upper

Jan 30, 2026

Upper · Passed

The committee(s) on HHS/LBT has scheduled a public hearing on 02-04-26 1:00PM; Conference Room 225 & Videoconference.

upper

Jan 26, 2026

Committee

Referred to HHS/LBT, CPN/WAM.

upper

Jan 21, 2026

Introduced

Introduced and passed First Reading.

upper

Jan 15, 2026

Introduced

Pending Introduction.

upper

11 primary · 0 co-sponsors