TITLE 27
Insurance
CHAPTER 27-20
Nonprofit Medical Service Corporations
SECTION 27-20-35.1
§ 27-20-35.1 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, 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 of 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.
(b) It remains within the sole discretion of the nonprofit
medical service corporation as to which registered nurse first assistant in
surgery it contracts with. Reimbursement is provided according to the
respective principles and policies of the nonprofit medical service
corporation: provided, that no nonprofit medical service corporation is
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 in this section precludes the nonprofit
medical service corporations from conducting managed care, medical necessity or
utilization review.
History of Section.
(P.L. 1999, ch. 509, § 3; P.L. 2002, ch. 292, § 39.)