(a) Any provider of
service required by chapter
386, HRS, this chapter, or any
related rules to make and submit reports of an injury and treatment shall:
(1) Submit those reports to the director and
the self-insured employer, or the insurer of the employer when the employer is
not self-insured, whichever is applicable; and
(2) Itemize its statement of services
rendered in a manner showing the date of injury, diagnosis, date of each visit
or service, the appropriate code number used as the basis for the charge, and
the fee not to exceed the maximum allowed under the medical fee schedule. No
service charge for preparing and submitting reports required by section
386-96,
HRS, and any related rules shall be allowed.
(3) Interim WC-2 reports shall be submitted
monthly with the corresponding billing invoice, if applicable, to the employer
and shall include the following:
(A) Current
diagnosis and prognosis;
(B)
Complete information as to the nature of the examination(s) and treatments
performed, dates of those treatments, and the results obtained within the
current reporting period;
(C) A
complete listing of all tests performed within the current reporting period and
the results of the tests;
(D) A
statement of whether the injured employee is improving, worsening, or if
"medical stabilization" has been reached; and
(E) Dates of disability, work restrictions,
if any, and return to work date.
(4) When an injured employee is returned to
full-time, regular, light, part-time, or restricted work, the attending
physician shall submit a report to the employer within seven calendar days
indicating the date of release to work or medical stabilization.
(b) Interim WC-2 reports and all
medical documentation shall be submitted by the employer to the director upon
submission of a "Request For Hearing" or within ten calendar days of a request
by the director. Any party who fails to furnish medical reports within ten
calendar days after being requested by the director may be subject to penalties
pursuant to section
386-97.5,
HRS.
(c) The repeated failure of a
physician, surgeon, hospital, or provider of service to comply with chapter
386, HRS, and any related rules shall
be a reasonable basis for an employer to refuse to pay or withhold payment for
services rendered.
