§ 27-19-27 - Certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists. - Rhode Island Statutes

SECTION 27-19-27

   § 27-19-27  Certified registered nursepractitioners and psychiatric and mental health nurse clinical specialists.– (a) Every health insurance contract, plan, or policy delivered, issued fordelivery, or renewed in this state shall provide coverage for the services of acertified registered nurse practitioner, practicing collaboratively, or inthe employ of a physician licensed under chapter 37 of title 5, andpsychiatric and mental health nurse clinical specialists, to subscribers ifthe services are within the certified registered nurse practitioner's orpsychiatric and mental health nurse clinical specialist's area of professionalcompetence as established by education and certification, and are currentlyreimbursed when rendered by any other licensed health care provider. No insureror hospital or medical service corporation may require signature by any otherhealth care provider as a condition of reimbursement. No insurer or hospital ormedical service corporation may be required to pay for duplicative servicesactually rendered by both a certified nurse practitioner and any other healthcare provider.

   (b) Nothing in this chapter shall preclude the conducting ofmanaged care reviews and medical necessity reviews by an insurer or hospital ormedical service corporation or health maintenance organization.

   (c) Every individual or group hospital or medical expenseinsurance policy or individual or group hospital or medical service plancontract delivered, issued for delivery, or renewed in this state shall providecoverage for certified registered nurse practitioners to provide primary care,intermediate, home, long-term and inpatient care as primary care providers,when said certified registered nurse practitioner is a participating provider,consistent with, and practicing within, the scope of his/her professionallicense.

   (d) Notwithstanding any law to the contrary, all insurers,nonprofit medical service corporations, nonprofit hospital service corporationsand health maintenance organizations shall provide subscribers with anopportunity to select a certified registered nurse practitioner, who is aparticipating provider, as a primary care provider.

   (e) Notwithstanding any law to the contrary, all insurers,nonprofit medical service corporations, nonprofit hospital service corporationsand health maintenance organizations shall insure that all participatingprimary care provider certified registered nurse practitioners are included onany publicly accessible list of participating providers for the respectiveorganization.