§ 27-41-39. Certified registered nurse practitioners and psychiatric and mental health nurse clinical
specialists.
(a) Every individual or group policy or contract delivered, issued for delivery, or renewed
by a health maintenance organization in this state shall provide coverage for the
services of certified registered nurse practitioners, practicing collaboratively,
and psychiatric and mental health nurse clinical specialists to subscribers, if those
services are within the certified registered nurse practitioner's or psychiatric and
mental health nurse clinical specialist's area of professional competence as established
by education and certification, and are currently reimbursed when rendered by any
other healthcare provider. No health maintenance organization may be required to pay
for duplicative services actually rendered by a certified nurse practitioner and any
other healthcare provider.
(b) Nothing in this chapter shall preclude the conducting of managed care reviews and
medical necessity reviews by an insurer or hospital or medical service corporation
or health maintenance organization.
(c) Every individual or group policy or contract delivered, issued for delivery, or renewed
by a health maintenance organization in this state shall provide coverage for certified
registered nurse practitioners to provide primary care, intermediate, home, long-term,
and inpatient care as primary care providers, when the certified registered nurse
practitioner is a participating provider, consistent with, and practicing within,
the scope of his or her professional license.
(d) Notwithstanding any law to the contrary, all insurers, nonprofit medical service corporations,
nonprofit hospital service corporations, and health maintenance organizations shall
provide subscribers with an opportunity to select a certified registered nurse practitioner,
who is a participating provider, as a primary care provider.
(e) Notwithstanding any law to the contrary, all insurers, nonprofit medical service corporations,
nonprofit hospital service corporations, and health maintenance organizations shall
insure that all participating primary care provider certified registered nurse practitioners
are included on any publicly accessible list of participating providers for the respective
organization.