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SB2663
THE SENATE
S.B. NO.
2663
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII
A BILL FOR AN ACT
Relating
to workers' compensation
.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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SECTION 1.
�
The legislature finds that timely approval or
denial of medical treatment plans is essential to the recovery of injured
employees under the State's workers' compensation system.
�
Existing law provides that a treatment plan
will be deemed accepted if the employer fails to file an objection and
supporting documentary evidence with the director of labor and industrial
relations.
�
However, the governing
statute does not include a timeframe within which employers must respond.
�
Without a clear written notice of acceptance
or denial within a reasonable timeframe, physicians are often hesitant to begin
treatment, which can delay necessary care for the injured employee.
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The
legislature further finds that while deadlines for an employer or insurer to
respond to a request are included in rules concerning treatments such as
concurrent medical treatment, consultations, and surgeries, a timeframe is
notably absent from the rules concerning physicians' general treatment plans.
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Furthermore, the workers' compensation system
would benefit from clarifying the employer's obligations, including the
implementation and payment of an approved treatment plan even if a subsequent
objection is raised based on new evidence, and establishing clear penalties for
noncompliance.
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Accordingly,
the purpose of this Act is to improve the State's workers' compensation system
and enforce accountability amongst employers by:
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(1)
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Requiring employers to approve or deny
a treatment plan in writing within seven days of its receipt;
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(2)
�
Clarifying the process for objecting to
accepted treatment plans; and
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(3)
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Establishing penalties for violations.
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SECTION
2
.
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Section
386-21.2, Hawaii Revised Statutes, is amended to read as follows:
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"[
[
]�386-21.2[
]
]
�
Treatment plans[
.
]
acceptance or denial by employer; penalty.
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(a)
�
A physician may transmit a treatment plan to an employer by mail or
facsimile; provided that the physician shall send the treatment plan to an
address or facsimile number provided by the employer.
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(b)
�
Beginning January 1, 2021, an employer shall
allow a physician to transmit a treatment plan to an employer by mail,
facsimile, or secure electronic means; provided that the physician shall send
the treatment plan to an address or facsimile number provided by the employer.
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(c)
�
A treatment plan shall be deemed received by
an employer when the plan is sent by mail or facsimile with reasonable evidence
showing that the treatment plan was received.
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(d)
�
[
A treatment plan shall be deemed accepted
if an employer fails to
]
No later than seven days after receipt of a
treatment plan, an employer shall transmit its written approval or denial of
the treatment plan to the physician and injured employee by mail, facsimile, or
secure electronic means; provided that the employer denying a treatment plan
shall
file with the director:
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(1)
�
An objection to the treatment plan;
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(2)
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Any applicable documentary evidence
supporting the denial; and
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(3)
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A copy of the denied treatment plan, copying
the physician and the injured employee[
.
]
,
no later
than seven days after receipt of the treatment plan.
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(e)
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Approval of a treatment plan by an
employer shall require the employer to pay the health care provider for any medical
care in the treatment plan pursuant to the medical fee schedule established pursuant
to section 386-21(c).
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(f)
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The burden of proof shall be on an
employer to demonstrate by a preponderance of medical evidence that a treatment
plan is unreasonable, unnecessary, or inappropriate to justify the issuance of
a denial pursuant to this section.
�
Denial
of a treatment plan that is not supported by a medical opinion or relevant
medical records existing at the time of the denial shall be presumed to be
without reasonable grounds.
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[
(e)
]
(g)
�
After [
acceptance
]
approval
of the treatment plan, an employer may file an objection to the plan if new
documentary evidence supporting the [
denial
]
objection
is
received by the employer[
.
]
; provided that an employer may not deny
implementation of and payment for any medical care in the approved treatment
plan until a hearing is held before the director and a decision is rendered
denying the treatment plan based on new documentary evidence.
�
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(h)
�
Any employer that fails to transmit written
approval or denial of a treatment plan
in compliance with the
timeline set forth in
subsection (d) shall be
subject
to a fine of $250 per day for each separate offense.
�
Each day of each violation shall constitute a
separate offense
.
�
The
fine shall be paid
to the injured employee.
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(i)
�
The director shall assess a penalty of not
less than $1,000 against any employer that the director finds has denied a
treatment plan or failed to pay for any medical care in an approved treatment
plan without reasonable grounds, frivolously, or primarily for purposes of
delay.
�
The penalty shall be paid to the
injured employee.
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An employer subject to
penalty under this subsection shall be liable for the injured employee's
reasonable attorney's fees and costs incurred in contesting the denial.
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(j)
�
Any action taken to impose or collect the fine
or penalty provided for in this section shall be considered a civil action.
"
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SECTION
3.
�
If any provision of this Act, or the
application thereof to any person or circumstance, is held invalid, the
invalidity does not affect other provisions or applications of the Act that can
be given effect without the invalid provision or application, and to this end
the provisions of this Act are severable.
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SECTION
4.
�
This Act does not affect rights and
duties that matured, penalties that were incurred, and proceedings that were
begun before its effective date.
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SECTION
5.
�
Statutory material to be repealed is
bracketed and stricken.
�
New statutory
material is underscored.
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SECTION
6.
�
This Act shall take effect upon its
approval.
INTRODUCED BY:
_____________________________
Report Title:
DLIR;
Workers' Compensation; Treatment Plans; Employers; Penalties
Description:
Requires
an employer to transmit written approval or denial of a treatment plan to the
physician who transmitted the plan for approval within seven days of receipt of
the plan.
�
Clarifies provisions relating
to denying a treatment plan, burden of proof, and objections.
�
Establishes fines and requires the Department
of Labor and Industrial Relations to assess penalties.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.