Rhode Island General Laws 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 that 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 healthcare 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.
Terms Used In Rhode Island General Laws 27-19-40.1
- 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.
- Healthcare services: means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Rhode Island General Laws 27-19-1
- 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
- Subscribers: as used in this chapter includes, in addition to those set forth in § 27-19-1, persons contracting with the corporation for coverage or benefits for medical services. See Rhode Island General Laws 27-19-17
(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 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. 509, § 2; P.L. 2002, ch. 292, § 37.