Formulary Accessibility Working Group

The Formulary Accessibility Working Group examines barriers that Hawaii residents face in accessing medications covered by insurance formularies, including step therapy requirements, prior authorization burdens, and formulary exceptions processes. It develops recommendations for regulatory or legislative action to improve patient access to medically necessary drugs. The group coordinates across the Insurance Division, health plans, providers, and patient advocates.

If your insurer has ever denied coverage for a medication your doctor prescribed, the rules this group helps shape determine your rights to appeal and exceptions. Patients experiencing formulary access barriers can bring their experiences to the attention of this working group.