Exempts from the general excise tax amounts received by a nurse entrepreneur for health care-related goods and services purchased under Medicaid, Medicare, or TRICARE.
Requires the Department of Human Services to allow a full earned income disregard for individuals with disabilities who are between the ages of sixteen and sixty-four years when determining eligibility for Medicaid. Takes effect upon approval by the Centers for Medicare and Medicaid Services. Effective 7/1/3000. (HD1)
Authorizes the Department of Health to accept accreditation or certification from an accreditation organization or a certification organization approved by the Centers for Medicare and Medicaid Services as demonstration that a licensed home health agency is in compliance with all licensing inspections required by the State. Specifies conditions under which a home health agency may be exempt from a licensing inspection on a continuing basis throughout the accreditation or certification period. Requires information obtained in reports of survey and accreditation or certification letters to be public information. (CD1)
Establishes a temporary Medi-Medi Project within the Hawaii State Health Insurance Assistance Program administered by the Executive Office on Aging to assist older adults, Medicare beneficiaries, individuals with disabilities, and other underserved populations who may qualify for various low-income subsidy programs to gain access to their benefits. Requires the Executive Office on Aging to submit reports to the Legislature. Appropriates funds.
Requires the Department of Human Services to provide Medicaid and Medicare part D prescription drug program recipients with coverage of glucagon-like peptide-1 (GLP-1) drugs for weight loss. Appropriates funds.
Expands the general excise tax exemption established by Act 47, Session Laws of Hawaii 2024, to include amounts received by optometrists, audiologists, and chiropractors, for healthcare-related goods or services purchased under the Medicare, Medicaid, and TRICARE programs.
Requires all accident and health or sickness insurers, mutual benefit societies, and health maintenance organizations operating in the State to adopt policies, procedures, and criteria for approving or denying requests for prior authorization that are the equivalent to the guidelines for prior authorization established by Medicare.
Establishes the Prior Authorization Committee to specify medical conditions for which prior authorization by the insurer for treatment is not required for health insurance coverage. Requires health plan insurers to align their prior authorization processes for other conditions with Medicare policies.
Requires all health care providers who accept Medicare to provide a cognitive assessment as part of the Medicare Part B annual wellness visit for Medicare beneficiaries sixty-five years of age or older, with certain exceptions. Requires health care providers to submit certain information to the Executive Office on Aging and the Executive Office on Aging to report de-identified aggregated data to the Legislature on an annual basis. Appropriates funds. Effective 1/1/2026.
Effective 1/1/2026, increases the employer base composite monthly contribution to the Hawaii Employer-Union Health Benefits Trust Fund by 5.2 percent of the 2025 employer base composite monthly contribution. Effective 1/1/2027, requires the calculation of employer base composite monthly contribution based on the change in Medicare Part B premiums from 2025 to 2026 and at two-year increments thereafter. Effective 7/1/3000. (HD1)
