TITLE 27
Insurance
CHAPTER 27-19
Nonprofit Hospital Service Corporations
SECTION 27-19-40.1
§ 27-19-40.1 Third party reimbursement for
services of registered nurse first assistants.
(a) 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 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 a registered nurse first
assistant provided, 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 (2) 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.
(b) 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, 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 in this section precludes the
nonprofit hospital service corporations from conducting managed care, medical
necessity or utilization review.
History of Section.
(P.L. 1999, ch. 509, § 2; P.L. 2002, ch. 292, § 37.)
