146             
HOUSE OF REPRESENTATIVES             H.C.R. NO.            
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                     HOUSE  CONCURRENT
                        RESOLUTION

  REQUESTING THE DIRECTOR OF LABOR AND INDUSTRIAL RELATIONS TO
    STUDY ALTERNATIVE APPROACHES TO REIMBURSING INDEPENDENT
    MEDICAL EXAMINATIONS.


 1        WHEREAS, employer requested medical examinations of
 2   claimants in workers' compensation cases, commonly referred to
 3   as independent medical examinations, are conducted by
 4   physicians or surgeons designated and paid by the employer; and
 5   
 6        WHEREAS, in reality, it is the insurer of the employer
 7   that designates the physician, and the same physicians are
 8   presented on various lists used by insurers because the great
 9   majority of the independent opinions rendered by these
10   physicians favor the insurer; and
11   
12        WHEREAS, some of these physicians are actually from out-
13   of-state; and
14   
15        WHEREAS, insurers pay physicians so generously for the
16   minimal amount of time spent on independent medical
17   examinations that a cottage industry has developed around
18   insurers and the physicians performing independent medical
19   examinations; and
20   
21        WHEREAS, this cottage industry has prospered at the
22   expense of workers' compensation claimants, who are forced to
23   seek medical assistance through other governmental programs
24   after treatment under workers' compensation is denied them by
25   their employers based on the opinion rendered pursuant to the
26   independent medical examination; now, therefore,
27   
28        BE IT RESOLVED by the House of Representatives of the
29   Twentieth Legislature of the State of Hawaii, Regular Session
30   of 1999, the Senate concurring, that the Director of Labor and
31   Industrial Relations is respectfully requested to study
32   alternative approaches to reimbursing independent medical
33   examinations, including the following:
34   
35        (1)  Allowing only the amount that the treating physician
36             is provided for a comprehensive examination and
37             narrative;

 
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 1   
 2        (2)  Paying the treating physician half the amount of the
 3             independent medical examination as the treating
 4             physician has to research and provide a report to
 5             defend the treatment plan; or
 6   
 7        (3)  Compose a panel of three physicians from three
 8             different health care professions picked by the
 9             respective professional association to review or
10             conduct independent medical examinations;
11   
12   and
13   
14        BE IT FURTHER RESOLVED that the Department of Labor and
15   Industrial Relations is also requested to study whether and to
16   what extent workers' compensation costs are increased due to
17   the insurer's practice of flying in out-of-state physicians to
18   perform independent medical examinations rather than having
19   those examinations performed by resident physicians; and
20   
21        BE IT FURTHER RESOLVED that the Director of Labor and
22   Industrial is requested to report findings and recommendations
23   to the Legislature twenty days prior to the Regular Session of
24   2000; and
25   
26        BE IT FURTHER RESOLVED that a certified copy of this
27   Concurrent Resolution be transmitted to the the Director of
28   Labor and Industrial Relations.
29 
30 
31 
32                         OFFERED BY:  ____________________________