STAND. COM. REP. NO.
Honolulu, Hawaii
APR 19 m
RE: H.C.R. No. 81
Honorable Ronald D. Kouchi
President of the Senate
Thirty-Second State Legislature
Regular Session of 2024
State of Hawaii
Sir:
Your Committees on Labor and Technology and Health and Human
Services, to which was referred H.C.R. No. 81 entitled:
"HOUSE CONCURRENT RESOLUTION REQUESTING THE DIRECTOR OF LABOR
AND INDUSTRIAL RELATIONS TO AMEND TITLE 12, CHAPTER 15,
HAWAII ADMINISTRATIVE RULES, TO CLARIFY THAT COMPENSATION FOR
ADVANCED PRACTICE REGISTERED NURSES UNDER THE STATE'S
WORKERS' COMPENSATION LAW IS DISTINCT FROM COMPENSATION FOR
REGISTERED NURSES AND SHALL BE ONE HUNDRED PERCENT OF THE
FEES AUTHORIZED UNDER THE MEDICARE FEE SCHEDULE,"
beg leave to report as follows:
The purpose and intent of this measure is to request the
Director of Labor and Industrial Relations to amend title 12,
chapter 15, Hawaii Administrative Rules, to clarify that
compensation for advanced practice registered nurses (APRNs) under
the State's Workers' Compensation Law is distinct from
compensation for registered nurses (RNs) and shall be one hundred
percent of the fees authorized under the Medicare fee schedule.
Your Committees received testimony in support of this measure
from the Hawaii's Affiliate of the American College of Nurse-
Midwives; Carol A. Orr, MD LLC; and four individuals.
Your Committees received comments on this measure from the
Hawai‘i State Center for Nursing.
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 STAND. COM. REP. NO.
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Your Committees find that existing rules adopted by the
Department of Labor and Industrial Relations pertaining to the
Workers' Compensation Medical Fee Schedule provide that fees for
services provided by assistants to providers of service, such as
licensed physician assistants and RNs, shall be eighty-five
percent of the fees authorized by the Medicare Fee Schedule. Your
Committees also find that in Hawaii, APRNs are distinct from RNs.
Specifically, APRNs are primary care providers whose scope of
practice exceeds that of RNs, and under the State's Workers'
Compensation Law, APRNs are included in the definitions of health
care provider and physician, who are entitled to receive one
hundred percent of the fees authorized under the Medicare Fee
Schedule. Your Committees find however,' that because the language
in the rules do not clearly distinguish APRNs from RNs, some
insurance companies, many on the mainland, refuse to reimburse
APRNs at a rate of one hundred percent, claiming that APRNs are
assistants to providers of service. Therefore, this measure
requests the Department of Labor and Industrial Relations to amend
the rules to clarify that APRNs are distinct from RNs and shall be
reimbursed at one hundred percent of the fees authorized by the
Medicare Fee Schedule.
As affirmed by the records of votes of the members of your
Committees on Labor and Technology and Health and Human Services
that are attached to this report, your Committees concur with the
intent and purpose of H.C.R. No. 81, and recommend its adoption.
Respectfully submitted on
behalf of the members of the
Committees on Labor and
Technology and Health and Human
Services,
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 The Senate
Thirty-Second Legislature
State of Hawaii
Record of Votes
Committee on Labor and Technology
LBT
Bill / Resolution No.:* Committee Referral: Date:
L£,T//Jt/b
__ The Committee is reconsidering its previous decision on this measure.
If so, then the previous decision was to;______________________________________
The Recommendation is:
lx Pass, unamended Pass, with amendments __ Hold __ Recommit
2312 2311 2310 2313
Members Aye (WR) Nay Excused
AQUINO, Henry J.C. (C)
MORIWAKI, Sharon Y. (VC)
IHARA, Jr., Les
LEE, Chris
FEVELLA, Kurt
Y
Recommendation:
TOTAL
/ J) A
'Adopted __ Not Adopted
Chair’s oKDesirfi^ee’s Signature:
Distribution: Original Yellow Pink Goldenrod
File with Committee Report Clerk's Office Drafting Agency Committee File Copy
*Only one measure per Record of Votes
Revised: 12/27/23
 The Senate
Thirty-Second Legislature
State of Hawai‘i
Record of Votes
Committee on Health and Human Services
HHS
Bill / Resolution No.:* Committee Referral: Date. /
Lev mn
__ The Committee is reconsidering its previous decision on this measure.
If so, then the previous decision was to:______________________________________
TheRepdmmendation is:
Pass, unamended Pass, with amendments __ Hold Recommit
2312 2311 2310 2313
Members Aye Aye (WR) Nay Excused
SAN BUENAVENTURA, Joy A. (C)
AQUINO, Henry J.C. (VC)
KEOHOKALOLE, Jarrett
SHIMABUKURO, Maile S.L
AWA, Brenton
TOTAL
Recommendation: X
1^ Adopted __ Not Adopted
Chair’s or Designee’s Signahjre^^^^^^,^-''^^_____
Distribution: Original Yellow Pink Goldenrod
File with Committee Report Clerk's Office Drafting Agency Committee File Copy
*Only one measure per Record of Votes
Revised: 12/27/23