2022 -- H 7394

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LC004472

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE

AND DISCIPLINE

     

     Introduced By: Representative Patricia A. Serpa

     Date Introduced: February 09, 2022

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 5-37 of the General Laws entitled "Board of Medical Licensure and

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Discipline" is hereby amended by adding thereto the following section:

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     5-37-2.2. Prohibition of board certification requirement to practice medicine.

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     Notwithstanding any provision of this chapter to the contrary, the board shall not require a

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physician applicant or physician licensee under its jurisdiction to obtain or maintain a national or

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regional board certification that is not otherwise specifically required in this chapter before it issues

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a license or license renewal to that physician applicant or physician licensee under this chapter.

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     SECTION 2. Section 27-20.6-1 of the General Laws in Chapter 27-20.6 entitled "Health

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Care Insurers - Coordination of Benefits" is hereby amended to read as follows:

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     27-20.6-1. Definitions.

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     As used in this chapter, the following terms shall have the following meanings:

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     (1) "Continued board certification" means an ongoing recertification program through

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which physicians are recertified in their medical specialty by one or more of the national or regional

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medical boards. Continued board certification is separate from and in addition to any recertification

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and continuing medical education requirements required pursuant to § 5-37-2.1;

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     (2) "Hospital" means a person or governmental entity licensed in accordance with chapter

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17 of title 23 to establish, maintain, and operate a hospital.

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     (1)(3) "Insurer" means every nonprofit medical service corporation, hospital service

 

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corporation, health maintenance organization, or other insurer offering and/or insuring health

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services; the term shall in addition include any entity defined as an insurer under § 42-62-4; and

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     (4) "Physician" means a person with a license to practice allopathic or osteopathic

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medicine; and

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     (2)(5) "Primary insurer" means the insurer primarily liable in accordance with the anti-

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duplication provisions established by regulations promulgated by the director of business

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regulation.

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     SECTION 3. Chapter 27-20.6 of the General Laws entitled "Health Care Insurers -

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Coordination of Benefits" is hereby amended by adding thereto the following section:

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     27-20.6-3.1. Continued board certification not to be considered in coordination of

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benefits.

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     (a) An insurer shall not deny reimbursement to a physician or hospital for services rendered

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because the physician or any physicians within the hospital have not completed continued board

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certification.

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     (b) An insurer shall not provide lower reimbursement for services rendered by a physician

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or hospital because the physician or any physicians within the hospital have not completed

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continued board certification.

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     (c) An insurer shall not prohibit a physician or hospital from participating in any of the

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insurer's provider networks because the physician or any physicians within the hospital have not

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completed continued board certification.

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     SECTION 4. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE

AND DISCIPLINE

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     This act would prohibit the board of medical licensure and discipline from requiring

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specialty board certification as a condition of licensure. This act also provides that a health care

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insurer shall not deny reimbursement or provide lower reimbursement rates to a physician or

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hospital, based on a physician's decision whether or not to participate in a national continued board

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certification program.

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     This act would take effect upon passage.

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