Maine Revised Statutes Title 24-A Sec. 4320-Q – Coverage for services provided by a certified registered nurse anesthetist
Current as of: 2023 | Check for updates
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(REALLOCATED FROM TITLE 24-A, SECTION 4320-P)
(REALLOCATED FROM TITLE 24-A, SECTION 4320-P)
1. Services provided by a certified registered nurse anesthetist. A carrier offering a health plan in this State shall provide coverage for health care services performed by a certified registered nurse anesthetist licensed under Title 32, chapter 31 when those services are covered services under the health plan when performed by any other health care provider and when those services are within the lawful scope of practice of the certified registered nurse anesthetist.
[PL 2021, c. 39, §1 (NEW); RR 2021, c. 1, Pt. A, §23 (RAL).]
Terms Used In Maine Revised Statutes Title 24-A Sec. 4320-Q
- Carrier: means :
A. See Maine Revised Statutes Title 24-A Sec. 4301-AContract: A legal written agreement that becomes binding when signed. Health plan: means a plan offered or administered by a carrier that provides for the financing or delivery of health care services to persons enrolled in the plan, other than a plan that provides only accidental injury, specified disease, hospital indemnity, Medicare supplement, disability income, long-term care or other limited benefit coverage not subject to the requirements of the federal Affordable Care Act. See Maine Revised Statutes Title 24-A Sec. 4301-A Provider: means a practitioner or facility licensed, accredited or certified to perform specified health care services consistent with state law. See Maine Revised Statutes Title 24-A Sec. 4301-A
2. Limits; deductible; copayment; coinsurance. A carrier may offer a health plan containing a provision for a deductible, copayment or coinsurance requirement for a health care service provided by a certified registered nurse anesthetist as long as the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to the same service provided by other health care providers.
[PL 2021, c. 39, §1 (NEW); RR 2021, c. 1, Pt. A, §23 (RAL).]
3. Network participation. A carrier may not prohibit a certified registered nurse anesthetist from participating in the carrier’s provider network or billing the carrier directly solely because the provider is a certified registered nurse anesthetist as long as the provider is willing to meet the same terms and conditions as other participating providers. This subsection does not require a carrier to contract with all certified registered nurse anesthetists or require a carrier to provide coverage under a health plan for any service provided by a participating certified registered nurse anesthetist that is not a covered service under the plan.
[PL 2021, c. 39, §1 (NEW); RR 2021, c. 1, Pt. A, §23 (RAL).]
4. Claim submission. Services billed by a certified registered nurse anesthetist must be submitted using the current standardized claim form for professional services approved by the Federal Government and submitted electronically.
[PL 2021, c. 39, §1 (NEW); RR 2021, c. 1, Pt. A, §23 (RAL).]
SECTION HISTORY
PL 2021, c. 39, §1 (NEW). RR 2021, c. 1, Pt. A, §23 (RAL).