HOUSE OF REPRESENTATIVES
H.B. NO.
1898
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII
A BILL FOR AN ACT
relating to health.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that recent changes to the immunization recommendations provided by the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services differ significantly from established medical standards and practice, such as the immunization recommendations provided by the American Academy of Pediatrics. The legislature also finds that insurance companies have only publicly committed to providing coverage of vaccines that were part of the Advisory Committee's recommendations made prior to September 2025 until the end of 2026. However, to protect the freedom of choice for the people of Hawaii to comprehensively consider the full range of prevailing medical standards when it comes to childhood immunization, there must be clarity regarding what their insurance will cover.
Accordingly, the purpose of this Act is to clarify that the department of health is to presume both the recommendations by the American Academy of Pediatrics and the recommendations by the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services constitute the prevailing medical standard for child health supervision services for purposes of health insurance coverage.
SECTION 2. Section 431:10A-115.5, Hawaii Revised Statutes, is amended to by amending subsections (b) and (c) to read as follows:
"(b) Child health supervision services shall include twelve visits at approximately the following intervals: birth; two months; four months; six months; nine months; twelve months; fifteen months; eighteen months; two years; three years; four years; and five years. Services to be covered at each visit shall include a history, physical examination, developmental assessment, anticipatory guidance, immunizations, and laboratory tests, in keeping with [Underlined: the] prevailing medical [[Struck through: standards.]] [Underlined: standard.] For purposes of this subsection, [[Struck through: the term "prevailing medical standards"]] [Underlined: "prevailing medical standard"] means the recommendations of the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services and the American Academy of Pediatrics; provided that if the recommendations of the committee and the academy differ, the department of health shall [[Struck through: determine which recommendations shall apply.]] [Underlined: presume that the recommendations of both the committee and the academy constitute the prevailing medical standard. The department shall only deviate from this presumption to recommend more comprehensive coverage or if the department finds, by clear and convincing evidence, that a specific recommendation is not in the best interests of public health.]
(c) Minimum benefits may be limited to one visit payable to one provider for all of the services provided at each visit cited in this section, except that the limitations authorized by this subsection shall not apply to immunizations recommended by the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services and the American Academy of Pediatrics; provided that if the recommendations of the committee and the academy differ, the department of health shall [[Struck through: determine which recommendations shall apply] [Underlined: presume that the recommendations of both the committee and the academy constitute the prevailing medical standard. The department shall only deviate from this presumption to recommend more comprehensive coverage or if the department finds, by clear and convincing evidence, that a specific recommendation is not in the best interests of public health.]"
SECTION 3. Section 431:10A-206.5, Hawaii Revised Statutes, is amended by amending subsections (b) and (c) to read as follows:
"(b) Child health supervision services shall include twelve visits at approximately the following intervals: birth; two months; four months; six months; nine months; twelve months; fifteen months; eighteen months; two years; three years; four years; and five years. Services to be covered at each visit shall include a history, physical examination, developmental assessment, anticipatory guidance, immunizations, and laboratory tests, in keeping with [Underlined: the] prevailing medical [[Struck through: standards.]] [Underlined: standard.] For purposes of this subsection, [[Struck through: the term "prevailing medical standards"]] [Underlined: "prevailing medical standard"] means the recommendations of the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services and the American Academy of Pediatrics; provided that if the recommendations of the committee and the academy differ, the department of health shall [[Struck through: determine which recommendations shall apply.]] [Underlined: presume that the recommendations of both the committee and the academy constitute the prevailing medical standard. The department shall only deviate from this presumption to recommend more comprehensive coverage or if the department finds, by clear and convincing evidence, that a specific recommendation is not in the best interests of public health.]
(c) Minimum benefits may be limited to one visit payable to one provider for all of the services provided at each visit cited in this section, except that the limitations authorized by this subsection shall not apply to immunizations recommended by the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services and the American Academy of Pediatrics; provided that if the recommendations of the committee and the academy differ, the department of health shall [[Struck through: determine which recommendations shall apply.]] [Underlined: presume that the recommendations of both the committee and the academy constitute the prevailing medical standard. The department shall only deviate from this presumption to recommend more comprehensive coverage or if the department finds, by clear and convincing evidence, that a specific recommendation is not in the best interests of public health.]"
SECTION 4. Section 432:1-602.5, Hawaii Revised Statutes, is amended by amending subsections (b) and (c) to read as follows:
"(b) Child health supervision services shall include twelve visits at approximately the following intervals: birth; two months; four months; six months; nine months; twelve months; fifteen months; eighteen months; two years; three years; four years; and five years. Services to be covered at each visit shall include a history, physical examination, developmental assessment, anticipatory guidance, immunizations, and laboratory tests, in keeping with [Underlined: the] prevailing medical [[Struck through: standards.]] [Underlined: standard.] For purposes of this subsection, [[Struck through: the term "prevailing medical standards"]] [Underlined: "prevailing medical standard"] means the recommendations of the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services and the American Academy of Pediatrics; provided that if the recommendations of the committee and the academy differ, the department of health shall [[Struck through: determine which recommendations shall apply.]] [Underlined: presume that the recommendations of both the committee and the academy constitute the prevailing medical standard. The department shall only deviate from this presumption to recommend more comprehensive coverage or if the department finds, by clear and convincing evidence, that a specific recommendation is not in the best interests of public health.]
(c) Minimum benefits may be limited to one visit payable to one provider for all of the services provided at each visit cited in this section, except that the limitations authorized by this subsection shall not apply to immunizations recommended by the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services and the American Academy of Pediatrics; provided that if the recommendations of the committee and the academy differ, the department of health shall [[Struck through: determine which recommendations shall apply.]] [Underlined: presume that the recommendations of both the committee and the academy constitute the prevailing medical standard. The department shall only deviate from this presumption to recommend more comprehensive coverage or if the department finds, by clear and convincing evidence, that a specific recommendation is not in the best interests of public health.]"
SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 6. This Act shall take effect upon its approval.
INTRODUCED BY:
_____________________________
Report Title:
Department of Health; Child Health Supervision Services; Immunization; Prevailing Medical Standard; Recommendations
Description:
Clarifies that the Department of Health is to presume both the recommendations by the American Academy of Pediatrics and the recommendations by the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services constitute the prevailing medical standard for child health supervision services for purposes of health insurance coverage.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.