Hawaii Administrative Rules › Title 12 - DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS › Chapter 15 - WORKERS COMPENSATION MEDICAL FEE SCHEDULE & EXHIBIT A › Subchapter 1 - GENERAL PROVISIONS › Section 12-15-1 - Definitions

Current through June, 2024
As used in this chapter:
"Advisory panel" means the advisory panel of health care
				  providers appointed by the director pursuant to section
				  386-27,
				  HRS.
"Appellate board" shall be as defined in section
				  386-1, HRS.
"Attending physician" shall be as defined in section
				  386-1, HRS.
"Bad faith," for the purposes of section
				  386-27,
				  HRS, and this chapter, requires a finding of a fraudulent, malicious,
				  dishonest, or frivolous act or omission. Mere carelessness, bad judgment, or
				  ordinary negligence, in and of themselves, do not constitute bad faith.
"Department" shall be as defined in section
				  386-1, HRS.
"Director" shall be as defined in section
				  386-1, HRS.
"Disability" shall be as defined in section
				  386-1, HRS.
"Disqualified health care provider" means a health care
				  provider barred under section
				  386-27,
				  HRS, from providing health care services to a person who has suffered a work
				  injury.
"Emergency medical services" shall be as defined in section
				  386-1, HRS.
"Employee" shall be as defined in section
				  386-1, HRS.
"Employer," as defined in section
				  386-1, HRS, includes
				  a self-insured employer or the self-insured employer's adjuster or designated
				  representative unless clearly indicated otherwise, the insurer of an employer,
				  or an employer who has failed to comply with section
				  386-121,
				  HRS.
"Employer's designated representative," for the purpose of
				  section
				  386-31(b)(1),
				  HRS, shall include:
(1) A self-insured employer's adjuster or attorney of
				  record;
(2) An insured employer's insurer, adjuster, or attorney of
				  record; or
(3) The adjuster or attorney of record of an uninsured
				  employer. "Guide" or "guidelines" shall be as defined in section
				  386-1, HRS. "Health
				  care provider" shall be as defined in section
				  386-1, HRS.
"Medical care," "medical services," or "medical supplies"
				  shall be as defined in section
				  386-1, HRS.
"Medical Fee Schedule" refers to the Medicare Resource Based
				  Relative Value Scale System applicable to Hawaii and the Workers' Compensation
				  Supplemental Medical Fee Schedule, Exhibit A, at the end of this
				  chapter.
"Physician" shall be as defined in section
				  386-1, HRS.
"Provider of service" means any person or entity who is
				  licensed, certified, recognized, or registered with the Department of Commerce
				  and Consumer Affairs and who renders medical care, medical services, or medical
				  supplies in accordance with chapter
				  386, HRS.
"Specialist" means a physician or surgeon who holds a
				  certification as a diplomate issued by a specialty board approved by the
				  American Medical Association or the American Dental Association.
"Therapist" means a duly licensed physical therapist or a
				  duly registered occupational therapist certified by the National Board for
				  Certification in Occupational Therapy, who renders therapy prescribed by a
				  physician.
"This statute" or "the statute" means chapter
				  386, HRS, unless otherwise
				  specified.
"Treatment" is defined as a visit to a provider of service
				  for the injury excluding consultations.
"Unqualified health care provider" means a health care
				  provider who is not qualified by the director under section
				  386-27,
				  HRS, to provide health care services to a person who has suffered a work
				  injury.
"Work injury" shall be as defined in section
				  386-1,
				  HRS.