TITLE 27
Insurance
CHAPTER 27-41
Health Maintenance Organizations
SECTION 27-41-49.1
§ 27-41-49.1 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, health maintenance organization,
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 designed as such;
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 health maintenance
organization has an alternative contractual relationship to fund the services
of a registered nurse first assistant.
(b) It remains within the sole discretion of the health
maintenance organization as to which registered nurse first assistant it
contracts with. Reimbursement provided according to the respective principles
and policies of the health maintenance organization; provided, that no health
maintenance organization 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 health maintenance organization from conducting managed care,
medical necessity or utilization review.
History of Section.
(P.L. 1999, ch. 509, § 4; P.L. 2002, ch. 292, § 85.)