Chapter 207
2005 -- H 5414
SUBSTITUTE B AS AMENDED
Enacted 07/08/05
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
Introduced
By: Representative Peter F. Kilmartin
Date
Introduced: February 09, 2005
It is enacted by the General Assembly as
follows:
SECTION 1. Section
23-17-51 of the General Laws in Chapter 23-17 entitled "Licensing
of Health Care Facilities" is hereby
amended to read as follows:
23-17-51.
Magnetic resonance imaging -- Quality assurance standards. -- Any
licensed health care facility performing a
magnetic resonance imaging examination shall be
accredited by the American College of Radiology.
(a) Except as
otherwise provided in subsection
(b) of this section, a magnetic resonance
imaging examination eligible for reimbursement
under the provisions of any individual or group
health insurance contract, plan or policy
delivered in this state shall be reimbursed only if the
facility at which the examination has been conducted
and processed is accredited by either the
American College of Radiology (ACR) or an
alternate nationally recognized accrediting
organization whose accreditation standards are
substantially similar to and
no less stringent than
current or subsequent ACR standards and have
been reviewed and deemed adequate by the
department of health. All accreditation
standards under this section, whether promulgated by the
ACR or an alternate nationally recognized accrediting
organization, shall include, but shall not be
limited to, provisions for establishing the
qualifications of the physician, standards for quality
control and routine performance monitoring by a
medical physicist, qualifications of the
technologist including minimum standards of
supervised clinical experience, personnel and
patient safety guidelines, and standards for
initial and ongoing quality control using clinical
image review and quantitative testing.
(b) Any
facility conducting and processing magnetic resonance imaging examinations
which, as of the effective date of this section,
is receiving reimbursement for such services by a
health insurer, health maintenance organization
or health plan, but is not accredited pursuant to
subsection (a), shall file its
application for accreditation within six (6) months of the effective date
of this section. Such accreditation shall be
obtained within eighteen (18) months of the effective
date of this section. A facility which begins
conducting and processing of magnetic resonance
imaging examinations after the effective date of
this section shall file its application for
accreditation within six (6) months of the date
of initiation of the magnetic resonance imaging
examinations. Such accreditation shall be
obtained within eighteen (18) months of the date of the
initiation of the magnetic resonance imaging
examinations. After such accreditation is obtained, a
facility conducting and processing magnetic
resonance imaging examinations shall, at all times,
maintain accreditation with the appropriate
accrediting body. Notwithstanding anything herein to
the contrary, any facility which has filed for
accreditation pursuant to this subsection (b) and
which has not been refused accreditation or withdrawn
its application, will be deemed
provisionally accredited for the eighteen (18)
month period dating from the application filing
date. Provided, further, that notwithstanding
any provision of the general laws or public laws to
the contrary, any facility conducting and
processing magnetic resonance imaging examinations
shall conform to the standards of the
appropriate accrediting body at all times, including during
the accreditation process and shall certify said
conformance to any reimbursing health insurer,
health maintenance organization or health plan.
SECTION 2. Section
27-18-53 of the General Laws in Chapter 27-18 entitled "Accident
and Sickness Insurance Policies" is hereby
amended to read as follows:
27-18-53. Magnetic
Resonance Imaging -- Quality assurance standards. -- A
magnetic resonance imaging examination eligible
for reimbursement under the provisions of any
individual or group health insurance contract,
plan or policy delivered in this state shall be
reimbursed only if the provider at which the
examination has been conducted and processed, and
the licensed physician interpreting the results
of the magnetic resonance imaging examination are
both accredited by the American College of
Radiology.
(a) Except as
otherwise provided in subsection
(b) of this section, a magnetic resonance
imaging examination eligible for reimbursement
under the provisions of any individual or group
health insurance contract, plan or policy delivered
in this state shall be reimbursed only if the
facility at which the examination has been
conducted and processed is accredited by either the
American College of Radiology (ACR) or an
alternate nationally recognized accrediting
organization whose accreditation standards are
substantially similar and no less stringent than
current or subsequent ACR standards and have
been reviewed and deemed adequate by the
department of health. All accreditation
standards under this section, whether promulgated by the
ACR or an alternate nationally recognized
accrediting organization, shall include, but shall not be
limited to, provisions for establishing the
qualifications of the physician, standards for quality
control and routine performance monitoring by a
medical physicist, qualifications of the
technologist including minimum standards of
supervised clinical experience, personnel and
patient safety guidelines, and standards for
initial and ongoing quality control using clinical
image review and quantitative testing.
(b) Any
facility conducting and processing magnetic resonance imaging examinations
which, as of the effective date of this section,
is receiving reimbursement for such services by a
health insurer, health maintenance organization
or health plan, but is not accredited pursuant to
subsectiion (a), shall file its
application for accreditation within six (6) months of the effective date
of this section. Such accreditation shall be
obtained within eighteen (18) months of the effective
date of this section. A facility which begins
conducting and processing, magnetic resonance
imaging examinations after the effective date of
this section shall file its application for
accreditation within six (6) months of the date
of initiation of the magnetic resonance imaging
examinations. Such accreditation shall be
obtained within eighteen (18) months of the date of the
initiation of the magnetic resonance imaging
examinations. After such accreditation is obtained, a
facility conducting and processing, magnetic
resonance imaging examinations shall, at all times,
maintain accreditation with the appropriate
accrediting body. Notwithstanding anything herein to
the contrary, any facility which has filed for
accreditation pursuant to this subsection (b) and has
not been refused accreditation or withdrawn its
application, will be deemed provisionally
accredited for the eighteen (18) month period
dating from the application filing date. Provided,
further, that notwithstanding any provision of
the general or public laws to the contrary, any
facility conducting and processing magnetic
resonance imaging examinations shall conform to
the standards of the appropriate accrediting
body at all times, including during said accreditation
process and shall certify said conformance to
any reimbursing health insurer, health maintenance
organization, or health plan.
SECTION 3. Section
27-19-46 of the General Laws in Chapter 27-19 entitled "Nonprofit
Hospital Service Corporations" is hereby
amended to read as follows:
27-19-46.
Magnetic resonance imaging -- Quality assurance standards. -- A
magnetic
resonance imaging examination eligible for
reimbursement by a nonprofit hospital services
corporation licensed pursuant to this chapter is
reimbursed only if the provider at which the
examination has been conducted and processed,
and the licensed physician interpreting the results
of the magnetic resonance imaging examination
are both accredited by the American College of
Radiology.
(a) Except as
otherwise provided in subsection
(b) of this section, a magnetic resonance
imaging examination eligible for reimbursement
under the provisions of any individual or group
health insurance contract, plan or policy
delivered in this state shall be reimbursed only if the
facility at which the examination has been
conducted and processed is accredited by either the
American College of Radiology (ACR) or an
alternate nationally recognized accrediting
organization whose accreditation standards are
substantially similar to and no less stringent than
current or subsequent ACR standards and have
been reviewed and deemed adequate by the
department of health. All accreditation
standards under this section, whether promulgated by the
ACR or an alternate nationally recognized
accrediting organization, shall include, but shall not be
limited to, provisions for establishing the
qualifications of the physician, standards for quality
control and routine performance monitoring by a
medical physicist, qualifications of the
technologist including minimum standards of
supervised clinical experience, personnel and
patient safety guidelines, and standards for
initial and ongoing quality control using clinical
image review and quantitative testing.
(b) Any
facility conducting and processing magnetic resonance imaging examinations
which, as of the effective date of this section,
is receiving reimbursement for such services by a
health insurer, health maintenance organization
or health plan, but is not accredited pursuant to
subsection (a), shall file its
application for accreditation within six (6) months of the effective date
of this section. Such accreditation shall be
obtained within eighteen (18) months of the effective
date of this section. A facility which begins
conducting and processing, of magnetic resonance
imaging examinations after the effective date of
this section shall file its application for
accreditation within six (6) months of the date
of initiation of the magnetic resonance imaging
examinations. Such accreditation shall be
obtained within eighteen (18) months of the date of the
initiation of the magnetic resonance imaging
examinations. After such accreditation is obtained, a
facility conducting and processing, of magnetic
resonance imaging examinations shall, at all
times, maintain accreditation with the
appropriate accrediting body. Notwithstanding anything
herein to the contrary, any facility which has
filed for accreditation pursuant to this subsection (b)
and which has not been refused accreditation or
withdrawn its application, will be deemed
provisionally accredited for the eighteen (18)
month period dating from the application filing
date. Provided, further, that notwithstanding
any provisions of the general or public laws to the
contrary, any facility conducting and processing
magnetic resonance imaging examinations shall
conform to the standards of the appropriate
accrediting body at all times, including during the
accreditation process and shall certify said
conformance to any reimbursing health insurer, health
maintenance organization or health plan.
SECTION 4. Section
27-20-41 of the General Laws in Chapter 27-20 entitled "Nonprofit
Medical Service Corporations" is hereby
amended to read as follows:
27-20-41.
Magnetic resonance imaging -- Quality assurance standards. -- A
magnetic
resonance imaging examination eligible for
reimbursement by a nonprofit medical service
corporation licensed pursuant to this chapter is
reimbursed only if the provider at which the
examination has been conducted and processed,
and the licensed physician interpreting the results
of the magnetic resonance imaging examination,
both meet state approved quality assurance
standards for taking, processing, and
interpreting magnetic resonance imaging examinations. The
director of health has the authority to
promulgate rules and regulations necessary to carry out the
provisions of this section. The rules and
regulations are based upon the most current standards of
the American College of Radiology.
(a) Except as
otherwise provided in subsection
(b) of this section, a magnetic resonance
imaging examination eligible for reimbursement
under the provisions of any individual or group
health insurance contract, plan or policy
delivered in this state shall be reimbursed only if the
facility at which the examination has been
conducted and processed is accredited by either the
American College of Radiology (ACR) or an
alternate nationally recognized accrediting
organization whose accreditation standards are
substantially similar to and no less stringent than
current or subsequent ACR standards and have
been reviewed and deemed adequate by the
department of health. All accreditation
standards under this section, whether promulgated by the
ACR or an alternate nationally recognized
accrediting organization, shall include, but shall not be
limited to, provisions for establishing the
qualifications of the physician, standards for quality
control and routine performance monitoring by a
medical physicist, qualifications of the
technologist including minimum standards of
supervised clinical experience, personnel and
patient safety guidelines, and standards for
initial and ongoing quality control using clinical
image review and quantitative testing.
(b) Any
facility conducting and processing magnetic resonance imaging examinations
which, as of the effective date of this section,
is receiving reimbursement for such services by a
health insurer, health maintenance organization
or health plan, but is not accredited pursuant to
subsection (a), shall file its
application for accreditation within six (6) months of the effective date
of this section. Such accreditation shall be
obtained within eighteen (18) months of the effective
date of this section. A facility which begins
conducting and processing, of magnetic resonance
imaging examinations after the effective date of
this section shall file its application for
accreditation within six (6) months of the date
of initiation of the magnetic resonance imaging
examinations. Such accreditation shall be
obtained within eighteen (18) months of the date of the
initiation of the magnetic resonance imaging
examinations. After such accreditation is obtained, a
facility conducting and processing, magnetic
resonance imaging examinations shall, at all times,
maintain accreditation with the appropriate
accrediting body. Notwithstanding anything herein to
the contrary, any facility which has filed for
accreditation pursuant to this subsection (b) and
which has not been refused accreditation or
withdrawn its application, will be deemed
provisionally accredited for the eighteen (18)
month period dating from the application filing
date. Provided, further, that notwithstanding
any provisions of the general or public laws to the
contrary, any facility conducting and processing
magnetic resonance imaging examinations shall
conform to the standards of the appropriate
accrediting body at all times, including during the
accreditation process and shall certify said
conformance to any reimbursing health insurer, health
maintenance organization or health plan.
SECTION 5. Section
27-41-56 of the General Laws in Chapter 27-41 entitled "Health
Maintenance Organizations" is hereby
amended to read as follows:
27-41-56.
Magnetic resonance imaging -- Quality assurance standards. -- A
magnetic
resonance imaging examination eligible for
reimbursement by a health maintenance organization
licensed pursuant to this chapter is reimbursed
only if the provider at which the examination has
been conducted and processed, and the licensed physician
interpreting the results of the magnetic
resonance imaging examination are both
accredited by the American College of Radiology.
(a) Except as
otherwise provided in paragraph (b) of this section, a magnetic resonance
imaging examination eligible for reimbursement
under the provisions of any individual or group
health insurance contract, plan or policy
delivered in this state shall be reimbursed only if the
facility at which the examination has been
conducted and processed is accredited by either the
American College of Radiology (ACR) or an
alternate nationally recognized accrediting
organization whose accreditation standards are
substantially similar to and no less stringent than
current or subsequent ACR standards and have
been reviewed and deemed adequate by the
department of health. All accreditation
standards under this section, whether promulgated by the
ACR or an alternate nationally recognized
accrediting organization, shall include, but shall not be
limited to, provisions for establishing the
qualifications of the physician, standards for quality
control and routine performance monitoring by a
medical physicist, qualifications of the
technologist including minimum standards of
supervised clinical experience, personnel and
patient safety guidelines, and standards for
initial and ongoing quality control using clinical
image review and quantitative testing.
(b) Any
facility conducting and processing magnetic resonance imaging examinations
which, as of the effective date of this section,
is receiving reimbursement for such services by a
health insurer, health maintenance organization
or health plan, but is not accredited pursuant to
subsection (a), shall file its application
for accreditation within six (6) months of the effective date
of this section. Such accreditation shall be
obtained within eighteen (18) months of the effective
date of this section. A facility which begins
conducting and processing, of magnetic resonance
imaging examinations after the effective date of
this section shall file its application for
accreditation within six (6) months of the date
of initiation of the magnetic resonance imaging
examinations. Such accreditation shall be
obtained within eighteen (18) months of the date of the
initiation of the magnetic resonance imaging
examinations. After such accreditation is obtained, a
facility conducting and processing, magnetic
resonance imaging examinations shall, at all times,
maintain accreditation with the appropriate
accrediting body. Notwithstanding anything herein to
the contrary, any facility which has filed for
accreditation pursuant to this subsection (b) and
which has not been refused accreditation or withdrawn
its application, will be deemed
provisionally accredited for the eighteen (18)
month period dating from the application filing
date. Provided, further, that notwithstanding
any provisions of the general or public laws to the
contrary, any facility conducting and processing
magnetic resonance imaging examinations shall
conform to the standards of the appropriate
accrediting body at all times, including during the
accreditation process and shall certify said
conformance to any reimbursing health insurer, health
maintenance organization or health plan.
SECTION
6. This act shall take effect on January 1, 2006.
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LC01382/SUB
B
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