All Roll Calls
Yes: 209 • No: 0
HawaiiHB 16432025–2026 Regular Session (Year 2)HouseWALLET
RELATING TO PHARMACY.
Sponsored By: Scot Z. Matayoshi (Democratic)
Signed by Governor
Summary
Specifies a framework for the administration of audits of records of registered pharmacists and pharmacies. Amends the definition of "pharmacy benefit manager" under chapter 431S, HRS, to exclude certain health maintenance organizations. Effective 7/1/3000. (SD2)
PharmacyRegistered PharmacistsAuditsPharmacy Benefit ManagersExclusionHealth Maintenance OrganizationIntegrated Delivery SystemHHS, CPN
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 1 benefits, 0 costs, 2 mixed.
Pharmacies get paid for package sizes
Pharmacies must be allowed to dispense and receive payment for the smallest commercially packaged product that contains the amount needed for the prescribed days’ supply. This applies even when the package exceeds the maximum days’ supply in the pharmacy’s agreement. Days’ supply uses the highest daily dose allowed by the prescriber, or the titration schedule for a prescription with changing doses. If a valid prescription for a covered person exceeds the maximum supply, recovery is limited to the cost of the extra amount, based on the original claim. These rules do not apply to an investigative audit alleging fraud or willful misrepresentation.
More notice and records for pharmacy audits
State and county payers, insurers, health plans, pharmacy benefit managers, and other listed entities must follow these audit rules. Hawaii Department of Health audits are excluded. The law counts contractors and employees who manage pharmacy benefits for covered entities as pharmacy benefit managers. It excludes certain fully integrated HMOs whose members mainly use HMO-owned pharmacies. Audits must begin with a written request acknowledged by signature. On-site audits require electronic notice at least two weeks ahead and enough information to identify the claims. Audits usually cover no more than two years of claims, unless federal rules require a longer period. Audits cannot start or be scheduled during the first seven days of a month without the pharmacy’s consent. Audits involving professional judgment must consult a knowledgeable pharmacist, and similar pharmacies must face the same standards. Pharmacies get the response time in their contract or manual, or at least 60 days if neither sets one. Preliminary reports are due within 120 days after the audit ends; final reports are due within six months after the preliminary report or final appeal, whichever is later. Pharmacies can use records from authorized health providers and legal prescriptions to support claims, and can reverse and rebill clerical corrections during the audit correction period. Findings cannot rely on missing information or its location when law does not require it, unless the parties agreed otherwise. Pharmacy benefit managers generally cannot share another manager’s audit information, except in investigations they reasonably believe involve fraud or willful misrepresentation.
Pharmacies face limits on audit recoupments
Auditors can recover only actual overpayments on claims disclosed in an audit. They cannot spread findings to other prescriptions. A projected amount is allowed only in a settlement the pharmacy accepts. Pharmacy benefit managers must offer an appeal, dismiss findings found unsupported, and wait until the internal appeal process ends before collecting disputed money. Clerical or recordkeeping errors alone are not fraud. They generally do not support criminal penalties without proof of intent, unless they caused an actual overpayment or the wrong medicine. Recovery of drug costs for clerical errors has exceptions for fraud or willful misrepresentation, dispensing beyond the plan contract, or dispensing against the prescriber’s order. A dispensing fee generally cannot be recovered for an overpayment, except when a prescription was not dispensed, was invalid or fraudulent, or was outside the contract. This fee rule does not apply to a contract-required correction of a good-faith claim error.
Sponsors & Cosponsors
Sponsor
Scot Z. Matayoshi
Democratic • House
Cosponsors
Cory M. Chun
Democratic • House
Tina Nakada Grandinetti
Democratic • House
Greggor Ilagan
Democratic • House
Darius K. Kila
Democratic • House
Lisa Marten
Democratic • House
Ikaika Olds
Democratic • House
Gregg Takayama
Democratic • House
David A. Tarnas
Democratic • House
Roll Call Votes
House vote • 5/6/2026
House Floor Vote
Yes: 51 • No: 0
Senate vote • 4/24/2026
The Conference committee recommends that the measure be PASSED, WITH AMENDMENTS....
Yes: 2 • No: 0
House vote • 4/24/2026
The Conference Committee recommends that the measure be Passed, with Amendments....
Yes: 4 • No: 0
Senate vote • 4/14/2026
Senate Floor Vote
Yes: 25 • No: 0
Senate vote • 4/7/2026
The committee(s) on CPN recommend(s) that the measure be PASSED, WITH AMENDMENT...
Yes: 4 • No: 0
Senate vote • 3/20/2026
The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENT...
Yes: 4 • No: 0
House vote • 3/10/2026
House Floor Vote
Yes: 50 • No: 0
House vote • 3/3/2026
The committee on CPC recommend that the measure be PASSED, WITH AMENDMENTS. The ...
Yes: 10 • No: 0
House vote • 2/18/2026
Passed Second Reading as amended in HD 1 and referred to the committee(s) on CPC...
Yes: 50 • No: 0
House vote • 2/13/2026
The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS. The ...
Yes: 9 • No: 0
Actions Timeline
Act 039, 05/26/2026 (Gov. Msg. No. 1139).
5/26/2026SenateAct 039, on 05/26/2026 (Gov. Msg. No. 1139).
5/26/2026HouseReceived notice of passage on Final Reading in House (Hse. Com. No. 888).
5/8/2026SenateTransmitted to Governor.
5/7/2026HousePassed Final Reading, as amended (CD 1). Ayes, 25; Aye(s) with reservations: none . 0 No(es): none. 0 Excused: none.
5/6/2026SenatePassed Final Reading as amended in CD 1 with none voting aye with reservations; none voting no (0) and none excused (0).
5/6/2026HouseReceived notice of Final Reading (Sen. Com. No. 816).
5/6/2026HouseReported from Conference Committee (Conf Com. Rep. No. 52-26) as amended in (CD 1).
4/29/2026HouseForty-eight (48) hours notice Wednesday, 05-06-26.
4/29/2026HouseReported from Conference Committee as amended CD 1 (Conf. Com. Rep. No. 52-26).
4/29/2026Senate48 Hrs. Notice (as amended CD 1) 05-06-26
4/29/2026SenateThe Conference Committee recommends that the measure be Passed, with Amendments. The votes were as follows: 4 Ayes: Representative(s) Takayama, Matayoshi, Keohokapu-Lee Loy, Alcos; Ayes with reservations: none; 0 Noes: none; and 0 Excused: none.
4/24/2026HouseThe Conference committee recommends that the measure be PASSED, WITH AMENDMENTS. The votes of the Senate Conference Managers were as follows: 2 Aye(s): Senator(s) McKelvey, Keohokalole; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Fevella.
4/24/2026SenateReceived notice of Senate conferees (Sen. Com. No. 725).
4/23/2026HouseBill scheduled for Conference Committee Meeting on Friday, 04-24-26 3:15PM in conference room 329.
4/23/2026HouseSenate Conferees Appointed: McKelvey Chair; Keohokalole Co-Chair; Fevella.
4/22/2026SenateHouse Conferees Appointed: Takayama, Matayoshi Co-Chairs; Keohokapu-Lee Loy, Alcos.
4/21/2026HouseReceived notice of appointment of House conferees (Hse. Com. No. 799).
4/21/2026SenateReceived notice of disagreement (Hse. Com. No. 780).
4/17/2026SenateHouse disagrees with Senate amendment (s).
4/16/2026HouseReport Adopted; Passed Third Reading, as amended (SD 2). Ayes, 25; Aye(s) with reservations: Senator(s) McKelvey. Noes, 0 (none). Excused, 0 (none). Transmitted to House.
4/14/2026SenateReturned from Senate (Sen. Com. No. 595) in amended form (SD 2).
4/14/2026HouseReported from CPN (Stand. Com. Rep. No. 3741) with recommendation of passage on Third Reading, as amended (SD 2).
4/10/2026Senate48 Hrs. Notice 04-14-26.
4/10/2026SenateThe committee(s) on CPN recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in CPN were as follows: 4 Aye(s): Senator(s) Keohokalole, Fukunaga, Lamosao; Aye(s) with reservations: Senator(s) McKelvey ; 0 No(es): none; and 1 Excused: Senator(s) Awa.
4/7/2026Senate
Bill Text
Bill Text
HB1643_CD1
HB1643_HD1
HB1643_HD2
HB1643_SD1
HB1643_SD2
Original
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