Rhode Island General Laws 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 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; 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 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 medical service corporation has an alternative contractual relationship to fund the services of a registered nurse first assistant.
Terms Used In Rhode Island General Laws 27-20-35.1
- 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 27-20-1
- Nonprofit medical service corporation: means any corporation organized pursuant hereto for the purpose of establishing, maintaining, and operating a nonprofit medical service plan. See Rhode Island General Laws 27-20-1
- provider: means a healthcare professional or a healthcare facility. See Rhode Island General Laws 27-20-1
- Subscribers: means those persons or groups of persons who contract with a nonprofit medical service corporation for medical service pursuant to a nonprofit medical service plan. See Rhode Island General Laws 27-20-1
(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 shall be 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 healthcare 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.