Introduced By: Senators Irons, Bates, Goodwin and Coderre
Date Introduced : February 9, 1999
It is enacted by the General Assembly:
SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance Policies" is hereby amended by adding thereto the following section:
{ADD 27-18-48.1. Third party reimbursement for services of registered nurse first assistants. -- ADD} {ADD Every individual or group hospital or medical services plan contract delivered, issued or renewed by an insurer or nonprofit health service corporation on or after January 1, 2000, which provides benefits to individual subscribers and members within the state, or to all group members having a principal place of employment within the state, shall provide benefits for services rendered by a registered nurse first assistant designated as such registered {ADD nurse ADD} first assistant provided, however, that the following conditions are met: (1) the registered nurse first assistant provides certain health care services under the supervision of a licensed physician; is currently licensed as a registered nurse in Rhode Island; has successfully completed a course in preparing the registered nurse as a first assistant in accordance with the Association of Operating Room Nurses core curriculum guide for the registered nurse first assistant and includes a minimum of one academic year in a college or university with didactic instruction and clinical internship programs; and is certified in perioperative nursing by the Certification Board Perioperative Nursing (minimum of two years perioperative experience); (2) the policy or contract, currently provides benefits for identical services rendered by a provider of health care licensed by the state; and (3) the registered nurse first assistant is not a salaried employee of the licensed hospital or facility for which the accident and sickness insurer has an alternative contractual relationship to fund the services of a registered nurse first assistant. ADD}
{ADD It shall remain within the sole discretion of the accident and sicknesses insurer as to which registered nurse first assistant it shall contract with. Reimbursement shall be provided according to the respective principles and policies of the health maintenance organization; provided, however, that no accident and sicknesses insurer may be required to provide direct reimbursement, or pay for duplicative services actually rendered by a registered nurse first assistant and any other health care provider. Nothing contained herein shall preclude the health maintenance organization from conducting managed care, medical necessity or utilization review; provided, however, that this section shall not apply to insurance coverage providing benefits for; (1) hospital confinement indemnity, (2) disability income, (3) accident only, (4) long term care, (5) Medicare supplement, (6) limited benefit health, (7) specified disease indemnity, (8) sickness or bodily injury or death by accident or both, and (9) other limited benefit policies. ADD}
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section:
{ADD 27-19-40.1 Third party reimbursement for services of registered nurse first assistants. -- ADD} {ADD Every individual or group health insurance contract, plan or policy delivered, issued or renewed by an insurer or nonprofit or for profit health service corporation on or after January 1, 2000, which provides benefits to individual subscribers and members within the state, or to all group members having a principal place of employment within the state, shall provide benefits for services rendered by a registered nurse first assistant designated as such registered nurse first assistant provided, however, that the following conditions are met: (1) the registered nurse first assistant provides certain health care services under the supervision of a licensed physician; is currently licensed as a registered nurse in Rhode Island; has successfully completed a course in preparing the registered nurse as a first assistant in accordance with the Association of Operating Room Nurses core curriculum guide for the registered nurse first assistant and includes a minimum of one academic year in a college or university with didactic instruction and clinical internship programs; and is certified in perioperative nursing by the Certification Board Perioperative Nursing (minimum of two years perioperative experience); (2) the policy or contract, currently provides benefits for identical services rendered by a provider of health care licensed by the state; and (3) the registered nurse first assistant is not a salaried employee of the licensed hospital or facility for which the nonprofit hospital service corporation has an alternative contractual relationship to fund the services of a registered nurse first assistant. ADD}
{ADD It shall remain within the sole discretion of the nonprofit hospital service corporation as to which registered nurse first assistant it shall contract with. Reimbursement shall be provided according to the respective principles and policies of the nonprofit hospital service corporation; provided, however, that no nonprofit hospital service corporation may be required to provide direct reimbursement, or pay for duplicative services actually rendered by a registered nurse first assistant in surgery and any other health care provider. Nothing contained herein shall preclude the nonprofit hospital service corporation from conducting managed care, medical necessity or utilization review. ADD}
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section:
{ADD 27-20-35.1 Third party reimbursement for services of registered nurse first assistants. -- ADD} {ADD Every individual or group health insurance contract, plan or policy delivered, issued or renewed by an insurer or nonprofit or for profit health service corporation on or after January 1, 2000, which provides benefits to individual subscribers and members within the state, or to all group members having a principal place of employment within the state, shall provide benefits for services rendered by a registered nurse first assistant, provided, however, that the following conditions are met: (1) the registered nurse first assistant provides certain health care services under the supervision of a licensed physician; is currently licensed as a registered nurse in Rhode Island; has successfully completed a course in preparing the registered nurse as a first assistant in accordance with the Association of Operating Room Nurses core curriculum guide for the registered nurse first assistant and includes a minimum of one academic year in a college or university with didactic instruction and clinical internship programs; and is certified in perioperative nursing by the Certification Board Perioperative nursing (minimum of two years perioperative experience); (2) the policy or contract, currently provides benefits for identical services rendered by a provider of health care licensed by the state; and (3) the registered nurse first assistant is not salaried employee of the licensed hospital or facility for which the nonprofit hospital service corporation has an alternative contractual relationship to fund the services of a registered nurse first assistant. ADD}
{ADD It shall remain within the sole discretion of the nonprofit medical service corporation as to which registered nurse first assistant in surgery it shall contract with. Reimbursement shall be provided according to the respective principles and policies of the nonprofit medical service corporation: provided, however, that no nonprofit medical service corporation may be required to provide direct reimbursement, or pay for duplicative services actually rendered by a registered nurse first assistant and any other health care provider. Nothing contained herein shall preclude the nonprofit medical service corporation from conducting managed care, medical necessity or utilization review. ADD}
SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section:
{ADD 27-41-49.1 Third party reimbursement for services of registered nurse first assistants. -- ADD} {ADD Every individual or group health insurance contract, plan or policy delivered, issued or renewed by an insurer, health maintenance organization, nonprofit or for profit health service corporation on or after January 1, 2000, which provides benefits to individual subscribers and members within the state, or to all group members having a principal place of employment within the state, shall provide benefits for services rendered by a registered nurse first assistant designed as such, provided, however, that the following conditions are met: (1) the registered nurse first assistant provides certain health care services under the supervision of a licensed physician; is currently licensed as a registered nurse in Rhode Island; has successfully completed a course in preparing the registered nurse as a first assistant in accordance with the Association of Operating Room Nurses core curriculum guide for the registered nurse first assistant and includes a minimum of one academic year in a college or university with didactic instruction and clinical internship programs; and is certified in perioperative nursing by the Certification Board Perioperative Nursing (minimum of two years perioperative experience); (2) the policy or contract, currently provides benefits for identical services rendered by a provider of health care licensed by the state; and (3) the registered nurse first assistant is not a salaried employee of the licensed hospital or facility for which the health maintenance organization has an alternative contractual relationship to fund the services of a registered nurse first assistant. ADD}
{ADD It shall remain within the sole discretion of the health maintenance organization as to which registered nurse first assistant it shall contract with. Reimbursement shall be provided according to the respective principles and policies of the health maintenance organization; provided, however, that no health maintenance organization may be required to provide direct reimbursement, or pay for duplicative services actually rendered by a registered nurse first assistant and any other health care provider. Nothing contained herein shall preclude the health maintenance organization from conducting managed care, medical necessity or utilization review. ADD}
SECTION 5. This act shall take effect on January 1, 2000.
