The following testimony was submitted by the Grassroot Institute of Hawaii for consideration by the House Committee on Consumer Protection & Commerce on March 3, 2026.
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March 3, 2026, 2 p.m.
Hawaii State Capitol
Conference Room 329 and Videoconference
To: House Committee on Consumer Protection & Commerce
Rep. Scot Z. Matayoshi, Chair
Rep. Tina Nakada Grandinetti, Vice Chair
From: Grassroot Institute of Hawaii
Ted Kefalas, Director of Strategic Campaigns
TESTIMONY IN SUPPORT OF HB2558 HD1 — RELATING TO TELEHEALTH
Aloha Chair, Vice Chair and other Committee members,
The Grassroot Institute of Hawaii supports HB2558 HD1, which would allow Hawaii residents greater access to telehealth services through out-of-state providers. We are, however, concerned that two elements of the current draft of the bill will frustrate this intent.
First, section 8(B) should be removed because it proposes limiting access to out-of-state telehealth to situations in which “The telemedicine service is not available in this State due to a physician shortage or lack of reasonable access.” This would create considerable ambiguity about the extent of unavailability required in order to legally seek telehealth services. For example, is it sufficient for a patient located on Maui to see a physician via telehealth if the only available specialist is on Oahu? What if there is a specialist on Maui, but that doctor has a lengthy waiting list? Or what if there is a physician on the island, but some feature of the patient’s illness would benefit from a higher degree of specialization in a particular area? One can see how this would become an interpretive and bureaucratic nightmare — not to mention the potential implications for insurance coverage.
Section 8(D) should also be removed. This provision defeats the purpose of the bill because it would require that out-of-state physicians provide telemedicine services to Hawaii patients under the supervision of a Hawaii-licensed doctor. A consulting exception already exists in Hawaii’s current telehealth law. Including that requirement here does nothing to help alleviate the healthcare and personnel shortages that prompted this bill, as a patient would be required to find an out-of-state doctor and a Hawaii doctor willing to work under these conditions, effectively making that patient wait in multiple lines instead of one.
A better way to address safety and oversight concerns regarding expanding telehealth services would be to create a registration system or special telehealth license for out-of-state telehealth providers that would fall under the supervision of the Hawaii Medical Board. Eighteen states, plus the Virgin Islands and Puerto Rico, have enacted some form of special license or registration system for out-of-state telehealth providers, and the majority of states have created exceptions to state licensing requirements for the practice of telehealth.
North Dakota, for example, allows patients who are in the state temporarily to receive telehealth care from licensed doctors who are in other states as long as the patient and physician have a preexisting relationship.
Florida has established a program that allows licensed out-of-state providers to practice telehealth by registering with the state medical board and agreeing to certain conditions such as liability coverage.
Colorado recently enacted an extensive out-of-state telehealth registration program that includes emergency protocols, practice standards and disclosure rules.
These states have also established safeguards to ensure that disciplinary actions against telehealth providers from out of state are reported to the state board, and that providers practicing telehealth within the state are subject to the jurisdiction of the state board.
Expanding access to telehealth by allowing residents to receive such healthcare services from qualifying out-of-state providers would be an easy, practical way to mitigate Hawaii’s struggles with healthcare access and staffing shortages, which disproportionately affect rural areas and underserved populations.
The COVID-19 crisis was instrumental in showing the potential telehealth has to improve healthcare outcomes. Moreover, emergency orders related to telehealth during that time demonstrated that removing barriers to out-of-state telehealth access benefitted patients and providers.
Grassroot has published a white paper that details how the state could improve outcomes and expand healthcare access by removing regulations that prevent Hawaii patients from receiving telehealth from out-of-state providers. Research demonstrates that improved adoption of and access to telehealth can lead to better health outcomes while reducing costs and unnecessary hospitalizations.
Moreover, safely increasing patient access to telehealth across state lines could help mitigate Hawaii’s physician and specialist shortages.
Hawaii’s geographic challenges make telehealth expansion a necessity. We commend the Legislature for seeking ways to remove barriers to telehealth in Hawaii.
Thank you for the opportunity to testify.
Ted Kefalas
Director of Strategic Campaigns
Grassroot Institute of Hawaii
