Hawaii

Key Provisions

• As Hawaii has no DPC-specific legislation, practices operate under the state's existing legal framework. There is no official state recognition of DPC as a distinct healthcare model, nor are there laws exempting it from insurance regulations.
• DPC practices in Hawaii rely on carefully constructed patient agreements. These contracts must explicitly state that the membership is not a health insurance plan and clearly define the scope of included services (e.g., routine and preventive care) versus excluded services (e.g., hospitalizations, specialty care).
• All physicians, including those in DPC, are governed by the Hawaii Medical Board. Practices must adhere to all standard requirements for physician licensing, scope of practice, medical record-keeping, and patient confidentiality.
• Patients in Hawaii are generally advised to pair a DPC membership with a separate health insurance plan to cover services not included in their agreement. DPC membership fees do not count toward insurance deductibles or out-of-pocket maximums.
• A key challenge for DPC in Hawaii is regulatory uncertainty. Without a formal opinion or ruling from the Hawaii Insurance Division, there remains ambiguity as to whether DPC arrangements could be considered the 'business of insurance,' which may deter some providers from adopting the model.