§ 27-18-48.1. Third-party reimbursement for services of registered nurse first assistants.
(a) Every individual or group hospital or medical services plan contract delivered, issued,
or renewed by an insurer or nonprofit 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, however, that the following conditions are met:
(1) The registe
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§ 27-18-48.1. Third-party reimbursement for services of registered nurse first assistants.
(a) Every individual or group hospital or medical services plan contract delivered, issued,
or renewed by an insurer or nonprofit 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, however, 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 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 accident and sickness insurer 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 accident and sicknesses insurer
as to which registered nurse first assistant it shall contract with. Reimbursement
shall be provided according to the respective principles and policies of the health
maintenance organization; provided, however, that no accident and sicknesses insurer
may be 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 shall preclude the health maintenance organization
from conducting managed care, medical necessity, or utilization review.
(c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital
confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care;
(5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity;
(8) Sickness or bodily injury or death by accident or both; and (9) Other limited
benefit policies.