It is enacted by the General Assembly as follows:

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 27-18-35. Certified counselors in mental health and therapists in marriage and family practice. -- ADD} {ADD Every health insurance contract plan or policy delivered, issued for delivery or renewed in this state on or after January 1, 1994, except policies which only provide coverage for specified diseases, fix indemnity, Medicare Supplement long term care disability income, or other limited benefit policies, shall provide coverage for the services of counselors in mental health certified pursuant to section 5-63-9 and therapists in marriage and family practice certified pursuant to section 5-63-8 excluding marital and family therapy unless the individual is diagnosed with a mental disorder. 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 27-19-31. Certified counselors in mental health and therapists in marriage and family practice. -- ADD} {ADD Every individual or group hospital or medical expense insurance policy or individual or group hospital or medical service plan contract delivered, issued for delivery or renewed in this state on or after January 1, 1994 will when deemed medically necessary by the nonprofit hospital service corporation in accordance with its standard medical management protocols and within the nonprofit hospital service corporation's subscriber contractual benefit limits, provide coverage for the services of counselors in mental health certified pursuant to section 5-63-9 and therapists in marriage and family practice certified pursuant to section 5-63-8. In the case of a limited provider network, it shall remain within the sole discretion of the nonprofit hospital service corporation as to which certified counselors in mental health and certified therapists in marriage and family practice with which it shall contact. Nothing contained herein shall require the nonprofit hospital service corporation to provide coverage other than in conjunction with a related medical illness. ADD}

SECTION 3. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section:

{ADD 27-41-40. Certified counselors in mental health and therapists in marriage and family practice. -- ADD} {ADD Every individual or group policy or contract delivered, issued for delivery or renewed by a health maintenance organization in this state on or after January 1, 1994 will, when deemed medically necessary by the health maintenance organization in accordance with its standard medical management protocols as approved by the health department and within the contractual benefit limits, provide coverage for the services of counselors in mental health certified pursuant to section 5-63-9 and therapists in marriage and family practice certified pursuant to section 5-63-8.

It shall remain within the sole discretion of the health maintenance organization as to which certified counselors in mental health and certified therapists in marriage and family practice it shall contract with. Nothing contained herein shall require the health maintenance organization to provide coverage other than in conjunction with a related medical illness. ADD}

SECTION 4. Sections 27-20-1 and 27-20-5 of the General Laws in Chapter 27-20 entitled "Nonprofit Medical Service Corporations" are hereby amended to read as follows:

{ADD 27-20-1. Definitions. -- ADD} (a) "Nonprofit medical service corporation" means any corporation organized pursuant hereto for the purpose of establishing, maintaining, and operating a nonprofit medical service plan.

(b) "Nonprofit medical service plan" means a plan whereby specified medical service is provided to subscribers to the plan by a nonprofit medical service corporation.

(c) "Medical services" means such professional services rendered by persons duly licensed under the laws of this state to practice medicine, surgery, chiropractic, podiatry, and such professional services rendered by a licensed midwife, certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists, and appliances, drugs, medicines, supplies and nursing care necessary in connection with such services, or the expense indemnity for the services, appliances, drugs, medicines, supplies and care, as may be specified in any nonprofit medical service plan. Medical service shall not be construed to include hospital services.

(d) "Subscribers" shall mean those persons or groups of persons who shall contract with a nonprofit medical service corporation for medical service pursuant to a nonprofit medical service plan.

(e) "Licensed Midwife" means any midwife licensed under section 23-13-9.

(f) "Certified registered nurse practitioners" is an expanded role utilizing independent knowledge of physical assessment and management of health care and illnesses. The practice includes collaboration with other licensed health care professional including but not limited to physicians, pharmacists, podiatrists, dentists and nurses.

(g) "Psychiatric and mental health nurse clinical specialist" is an expanded role utilizing independent knowledge and management of mental health and illnesses. The practice includes collaboration with other licensed health care professionals, including but not limited to psychiatrists, psychologists, physicians, pharmacists, and nurses.

{ADD (h) "Counselor in mental health" means a person who has been certified pursuant to section 5-63-9.

(i) "Therapist in marriage and family practice" means a person who has been certified pursuant to section 5-63-8. ADD}

{ADD 27-20-5. Contracts with subscribers. -- ADD} Each nonprofit medical service corporation may contract with its subscribers for such medical service as may be from time to time provided under any nonprofit medical service plan adopted by the corporation; provided, that if any medical service as may be provided for from time to time shall include service which may be lawfully performed or rendered by a podiatrist, the contract shall provide for the payment for such service so performed or rendered by a podiatrist; provided further, that if any medical service as may be provided for from time to time shall include service which may be lawfully performed or rendered by a certified registered nurse practitioner or psychiatric and mental health nurse clinical specialist such contract will provide for the payment for such service so performed or rendered by a certified registered nurse practitioner or psychiatric and mental health nurse clinical specialist to subscribers. No nonprofit medical service corporation may require supervision, signature or referral by any other health care provider as a condition of reimbursement to a certified registered nurse practitioner, provided that no nonprofit medical service corporation may be required to pay for duplicative services actually rendered by both a certified registered nurse practitioner and any other health care provider; and further provided that if any medical service as may be provided for from time to time shall include service which may be lawfully performed or rendered by a licensed midwife, such contract delivered, issued for delivery or renewed in this state on or after January 1991, shall provide for the payment for such service so performed or rendered by a licensed midwife in accordance with each health insurers' respective principles and mechanisms of reimbursement credentialing and contracting if such services are within the licensed midwives' area of professional competence as defined by regulations promulgated pursuant to section 23-13-9, and are currently reimbursed when rendered by any other licensed health care provider. No nonprofit medical service corporation may require supervision, signature or referral by any other health care provider as a condition of reimbursement except when such requirements are also applicable to other categories of health care providers. Provided no insurer or hospital or medical service corporation or patient may be required to pay for duplicate services actually rendered by both a licensed midwife and any other health care provider. Direct payment for licensed midwives will be contingent upon services rendered in a licensed health care facility and for services rendered in accordance with rules and regulations promulgated by the department of health. Provided, however, that this provision shall not prohibit payment for services pursuant to section 42-62-26 of the general laws or for other services reimbursed by third party payors {ADD and provided further that if any medical service which may be provided for from time to time shall include service which may be rendered by a counselor in mental health or a therapist in marriage and family practice, excluding marital and family therapy unless there is an individual diagnosed with a mental disorder, the contract shall provide for payment for the service so performed or rendered when deemed medically necessary by the nonprofit medical service corporation in accordance with its standard medical management protocols and within the nonprofit medical service corporation's subscriber contractual limits. In the case of a limited provider network, it shall remain within the sole discretion of the nonprofit medical service corporation as to which certified counselors in mental health and certified therapists in marriage and family practice with which it shall contract. Nothing contained herein shall require the nonprofit medical service corporation to provide coverage other than in conjunction with a related medical illness. ADD}

SECTION 5. This act shall take effect upon passage.