(a)  Every group health insurance contract, plan, or group policy delivered, issued for delivery, or renewed in this state that provides medical coverage, and every group policy that provides for treatment of persons for the prevention, cure, or correction of any illness or physical or mental condition, shall provide, as an optional rider, coverage for the services of a doctor of acupuncture as a provider of acupuncture services.

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Terms Used In Rhode Island General Laws 27-19-47

  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Nonprofit hospital service corporation: means any corporation organized pursuant to this chapter for the purpose of establishing, maintaining, and operating a nonprofit hospital service plan. See Rhode Island General Laws 27-19-1
  • provider: means a healthcare professional or a healthcare facility. See Rhode Island General Laws 27-19-1

(b)  For the purposes of this section:

(1)  “Coverage for the services of a doctor of acupuncture as a provider of acupuncture services” means coverage for acupuncture as defined in § 5-37.2-2(1).

(2)  “Doctor of acupuncture” means a practitioner licensed under chapter 37.2 of Title 5.

(c)  It remains within the sole discretion of the nonprofit hospital service corporation as to which doctor of acupuncture 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 is required to pay for duplicative services actually rendered by a doctor of acupuncture and any other healthcare 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. 288, § 2.