§ 27-41-49.1. 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, health maintenance organization, 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 such; provided, that the following conditions are met:
(1) The
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§ 27-41-49.1. 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, health maintenance organization, 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 such; 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 health maintenance organization has an alternative contractual
relationship to fund the services of a registered nurse first assistant.
(b) It remains within the sole discretion of the health maintenance organization as to
which registered nurse first assistant it contracts with. Reimbursement shall be provided
according to the respective principles and policies of the health maintenance organization;
provided, that no health maintenance organization 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
health maintenance organization from conducting managed care, medical necessity, or
utilization review.