§ 27-41-39 - Certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists. - Rhode Island Statutes

SECTION 27-41-39

   § 27-41-39  Certified registered nursepractitioners and psychiatric and mental health nurse clinical specialists.– (a) Every individual or group policy or contract delivered, issued fordelivery, or renewed by a health maintenance organization in this state shallprovide coverage for the services of certified registered nurse practitioners,practicing collaboratively and psychiatric and mental health nurse clinicalspecialists to subscribers, if those services are within the certifiedregistered nurse practitioner's or psychiatric and mental health nurse clinicalspecialist's area of professional competence as established by education andcertification, and are currently reimbursed when rendered by any other healthcare provider. No health maintenance organization may be required to pay forduplicative services actually rendered by a certified nurse practitioner andany other health care 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 policy or contract delivered,issued for delivery, or renewed by a health maintenance organization in thisstate shall provide coverage for certified registered nurse practitioners toprovide primary care, intermediate, home, long-term and inpatient care asprimary care providers, when said certified registered nurse practitioner is aparticipating provider, consistent with, and practicing within, the scope ofhis/her professional license.

   (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.