Haw. Code R. § 12-15-13

Current through November, 2024

Section 12-15-13 - Health care provider standards

Any health care provider who is found to be in violation of any one or more of the following standards shall, after hearing, be subject to the sanctions and penalties pursuant to section 12-15-14 or any other applicable provision in the statute:

(1) Failure, neglect, or refusal to submit complete, adequate, and detailed reports as defined in the statute;

(2) Failure, neglect, or refusal to respond to the director's written request for additional reports;

(3) Failure, neglect, or refusal to observe and comply with the statue;

(4) Failure, neglect, or refusal to comply with the Department's written rules, determinations, or decisions;

(5) Persistent refusal to consider the recommendations of board certified or qualified health care providers in the provider's specialty field who have examined the injured employee, without providing adequate reasons for such refusal;

(6) Repeated submission of false or misleading reports;

(7) Collusion with any other person in the submission of false or misleading information;

(8) Submission of inaccurate, misleading, or duplicate bills;

(9) Persistent submission of false or erroneous diagnosis;

(10) Use of treatment that is:

(A) Contraindicated or hazardous; or

(B) Excessive in frequency or duration;

(11) Charging or attempting to charge any fee to an industrially injured employee for the care of the industrial injury or billing the employer more than the fee allowed under section 12-15-90;

(12) Charging fees to an injured employee which have been disallowed or forfeited;

(13) Prescription of narcotic, addictive, habituating, or dependency inducing drugs in any way other than for therapeutic purposes;

(14) Acts of gross misconduct in the practice of the profession;

(15) Failure to treat a work injury for other than ethical or other valid considerations under the statute;

(16) Failure, neglect, or refusal to insure compliance by a provider of service under the health care provider's direction as required under this chapter.

Haw. Code R. § 12-15-13

[Eff 1/1/96] (Auth: HRS §§ 386-27, 386-72) (Imp: HRS § 386-27)