2019 -- H 5247

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LC001104

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE

AND DISCIPLINE

     Introduced By: Representatives Lima, Williams, and Bennett

     Date Introduced: January 31, 2019

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 5-37 of the General Laws entitled "Board of Medical Licensure and

Discipline" is hereby amended by adding thereto the following section:

     5-37-2.2. Election as to participation in maintenance of effort programs.

     (a) Definitions. As used in this section:

     (1) "Hospital" has the same meaning as defined in § 23-17-2.

     (2) "Maintenance of certification" means a continuous professional development program

through which physicians are certified by one or more of the nationally recognized medical

specialty boards. Maintenance of certification is separate from and in addition to any

recertification and continuing medical education requirements required pursuant to § 5-37-2.1.

     (3) "Physician" has the same meaning as defined in § 23-17-2.

     (b) Maintenance of certification by hospital physicians.

     (1) The medical staff (the staff) at any hospital shall decide by majority vote whether to

require the staff to participate in a maintenance of certification program or programs. A hospital

shall not impose a requirement that the staff participate in a maintenance of certification program

without an affirmative vote by the staff to do so as provided by this section. No maintenance of

certification program requirements shall be enforced at any hospital unless the staff affirmatively

votes to impose such requirements.

     (2) In the event the staff elects to participate in a maintenance of certification program,

the staff shall also decide by majority vote, which medical specialty board the staff shall utilize to

implement the maintenance of certification program.

     (3) A vote whereby the staff affirmatively agrees to participate in a maintenance of

certification program shall remain in effect for a period of time as determined by a majority vote

of the staff, and shall be binding upon any physician who is or who seeks to become a staff

member or have admitting privileges at the hospital at any time while the certification program is

in effect.

     SECTION 2. Chapter 27-20.6 of the General Laws entitled "Health Care Insurers -

Coordination of Benefits" is hereby amended by adding thereto the following section:

     27-20.6-3.1. Maintenance of certification not to be considered in coordination of

benefits.

     A health care insurer shall not deny reimbursement or discriminate in reimbursement

rates to a physician or hospital, nor prevent a physician or hospital from participating in any of

the insurer's provider networks, based solely on a physician’s decision not to participate in any

form of maintenance of certification, or a decision made by a hospital’s medical staff as to

whether or not to participate in a maintenance certification program or, if there is an election to

participate, then upon the particular medical specialty board that is chosen, pursuant to § 5-37-

2.2.

     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE

AND DISCIPLINE

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     This act would authorize hospital medical staff to elect whether or not to participate in a

maintenance of certification program. If the staff elects to participate in such a program, the staff

would also elect the medical specialty board the staff would utilize to implement the maintenance

of certification program. This act would also prohibit health care insurers from denying

reimbursement to a physician or hospital based solely upon this election.

     This act would take effect upon passage.

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