§ 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 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 designated as a registered nurse first assistant 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 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.
(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 health care 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.
Structure Rhode Island General Laws
Chapter 27-19 - Nonprofit Hospital Service Corporations
Section 27-19-1. - Definitions.
Section 27-19-2. - Organization as charitable corporation — Insurance laws inapplicable.
Section 27-19-2.1. - Investments and holdings in certain corporations authorized.
Section 27-19-4. - Certificate of public convenience and advantage.
Section 27-19-5. - Contracts with subscribers, hospitals, and other eligible entities.
Section 27-19-5.1. - Cancellation of coverage by employers.
Section 27-19-5.2. - Patient responsibility — Administrative requirements.
Section 27-19-5.3. - Additional powers.
Section 27-19-6. - Rates charged subscribers — Reserves. [Effective until January 1, 2023.]
Section 27-19-7. - Rates charged by hospitals.
Section 27-19-7.1. - Uniform explanation of benefits and coverage.
Section 27-19-7.2. - Filing of policy forms.
Section 27-19-8. - Annual and quarterly statements.
Section 27-19-9. - Examination of affairs of corporations.
Section 27-19-10. - Commission plans for solicitors or insurance producers.
Section 27-19-11. - Investment standards.
Section 27-19-12. - Corporations deemed public charitable institutions.
Section 27-19-13. - Services rendered in certain institutions.
Section 27-19-17. - Additional benefits.
Section 27-19-18. - Coverage for adoptive children.
Section 27-19-19. - Changing coverage.
Section 27-19-20. - Mammograms and pap smears — Coverage mandated.
Section 27-19-21. - Mammograms — Quality assurance standards.
Section 27-19-22. - Pap smears — Quality assurance standards.
Section 27-19-23. - Coverage for infertility.
Section 27-19-23.1. - Insurance coverage for post-partum hospital stays.
Section 27-19-24. - Nonprofit hospital service corporations assessment.
Section 27-19-25. - Discontinuance of coverage — Chronic disabilities.
Section 27-19-26. - Drug coverage.
Section 27-19-26.1. - Medication synchronization.
Section 27-19-28. - Rehabilitation, liquidation, or conservation.
Section 27-19-29. - Holding company systems.
Section 27-19-29.1. - No derogation of attorney general.
Section 27-19-30. - Regulations.
Section 27-19-30.1. - Health insurance rates.
Section 27-19-32.1. - Repealed.
Section 27-19-32.2. - Repealed.
Section 27-19-32.3. - Repealed.
Section 27-19-34. - Mastectomy treatment.
Section 27-19-34.1. - Insurance coverage for mastectomy hospital stays.
Section 27-19-35. - Diabetes treatment.
Section 27-19-36. - Primary and preventive obstetric and gynecological care.
Section 27-19-36.1. - Hysterectomy or myomectomy treatment.
Section 27-19-37. - Whistleblowers protection.
Section 27-19-38. - Penalties and remedies.
Section 27-19-39. - Additional relief and damages — Reinstatement.
Section 27-19-40. - Third-party reimbursement for services of certain healthcare workers.
Section 27-19-40.1. - Third party reimbursement for services of registered nurse first assistants.
Section 27-19-41. - Human leukocyte antigen testing.
Section 27-19-42. - Drug coverage.
Section 27-19-43. - Restricted annual rate payments prohibited.
Section 27-19-44. - Genetic testing.
Section 27-19-44.1. - Genetic information.
Section 27-19-46. - Magnetic resonance imaging — Quality assurance standards.
Section 27-19-47. - Acupuncture services.
Section 27-19-48. - F.D.A. approved prescription contraceptive drugs and devices.
Section 27-19-50. - Eligibility for children’s benefits.
Section 27-19-51. - Hearing aids.
Section 27-19-52. - Prompt processing of claims.
Section 27-19-53. - Mandatory coverage for certain lyme disease treatments.
Section 27-19-54. - Dental insurance assignment of benefits.
Section 27-19-55. - Coverage for early intervention services.
Section 27-19-56. - Post-payment audits.
Section 27-19-57. - Tobacco cessation programs.
Section 27-19-58. - Reimbursement for orthotics and prosthetic services.
Section 27-19-59. - Mandatory coverage for scalp hair prosthesis.
Section 27-19-60. - Licensed ambulance service.
Section 27-19-61. - Enteral nutrition products.
Section 27-19-62. - Prohibition on rescission of coverage.
Section 27-19-63. - Prohibition on annual and lifetime limits.
Section 27-19-64. - Coverage for individuals participating in approved clinical trials.
Section 27-19-65. - Medical loss ratio reporting and rebates.
Section 27-19-66. - Emergency services.
Section 27-19-67. - Internal and external appeal of adverse benefit determinations.
Section 27-19-68. - Prohibition on preexisting condition exclusions.
Section 27-19-69. - Primary care provider designation requirement.
Section 27-19-70. - Discretionary clauses.
Section 27-19-71. - Orally administered anticancer medication — Cost-sharing requirement.
Section 27-19-72. - Consumer notification.
Section 27-19-73. - Opioid antagonists.
Section 27-19-74. - Healthcare provider credentialing.
Section 27-19-75. - Unfair discrimination prohibited.
Section 27-19-76. - Health insurance contracts — Full year coverage for contraception.
Section 27-19-77. - Prohibition on discrimination in organ transplants.
Section 27-19-78. - Health insurance contracts — Copayments exemption for COVID-19 vaccinations.
Section 27-19-79. - Perinatal doulas.
Section 27-19-80. - Gender rating. [Effective January 1, 2023.]