Haw. Code R. § 12-15-1

Current through September, 2024
Section 12-15-1 - Definitions

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.

Haw. Code R. § 12-15-1

[Eff 1/1/96, am 12/13/04; am 2/28/11] (Auth: HRS §§ 386-21, 386-26, 386-27, 386-72) (Imp: HRS §§ 386-1, 386-2, 386-21, 386-23, 386-27)