Report Title:

Workers' Compensation; Patient Referrals; Restrictions

Description:

Prohibits a health care provider from referring a workers' compensation claimant to a non-diagnostic treatment or rehabilitative service corporation or other business entity in which the referring health care provider owns a proprietary interest. Exempts referrals made by health care providers employed by health maintenance organizations from the prohibition.

HOUSE OF REPRESENTATIVES

H.B. NO.

1828

TWENTY-THIRD LEGISLATURE, 2006

  

STATE OF HAWAII

  

 

A BILL FOR AN ACT

 

relating to workers' compensation.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 2. Section 386-27, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

"(b) To remain a qualified provider under this chapter a health care provider shall:

(1) Comply with guidelines established by the director on the frequency of treatment and reasonable utilization of health care and services;

(2) Conform to limitations established by the director for charges on services under medical fee and other fee schedules;

(3) File timely reports required under section 386-96;

(4) Avoid unnecessary and unreasonable referrals of injured employees to other health care providers;

(5) Refrain from ordering unnecessary and unreasonable diagnostic tests and studies;

(6) Refrain from referring injured employees to a non-diagnostic or rehabilitative services corporation or other business entity in which the referring health care provider who, through a familial relationship within the second degree of consanguinity of affinity or for other reasons, had a direct and substantial professional, financial, or personal interest; provided that this paragraph shall not apply to referrals made by health care providers within a health maintenance organization established pursuant to chapter 432D;

[(6)] (7) Remain available as a treating health care provider to injured employees and as an advisor to the director in proceedings under this section; and

[(7)] (8) Comply with all requirements established under this chapter and by rules and decisions adopted and issued by the director pursuant to this chapter."

SECTION 2. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 3. This Act shall take effect upon its approval.

INTRODUCED BY:

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