2020 -- S 2531 | |
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LC004652 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2020 | |
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A N A C T | |
RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE | |
AND DISCIPLINE | |
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Introduced By: Senators Sheehan, Crowley, Picard, Metts, and Satchell | |
Date Introduced: February 25, 2020 | |
Referred To: Senate Health & Human Services | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Chapter 5-37 of the General Laws entitled "Board of Medical Licensure and |
2 | Discipline" is hereby amended by adding thereto the following section: |
3 | 5-37-2.2. Prohibition of board certification requirement to practice medicine. |
4 | Notwithstanding any provision of this chapter to the contrary, the board shall not require a |
5 | physician applicant or physician licensee under its jurisdiction to obtain or maintain a national or |
6 | regional board certification that is not otherwise specifically required in this chapter before it issues |
7 | a license or license renewal to that physician applicant or physician licensee under this chapter. |
8 | SECTION 2. Section 27-20.6-1 of the General Laws in Chapter 27-20.6 entitled "Health |
9 | Care Insurers - Coordination of Benefits" is hereby amended to read as follows: |
10 | 27-20.6-1. Definitions. |
11 | As used in this chapter, the following terms shall have the following meanings: |
12 | (1) “Continued board certification” means an ongoing recertification program through |
13 | which physicians are recertified by one or more of the national or regional medical boards, which |
14 | includes, but is not limited to, one or more of the medical specialty boards of the American Board |
15 | of Medical Specialties, the American Osteopathic Association, the National Board of Physicians |
16 | and Surgeons, or any other nationally or regionally-recognized entity providing medical specialty |
17 | certification. Continued board certification is separate from and in addition to any recertification |
18 | and continuing medical education requirements required pursuant to § 5-37-2.1. |
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1 | (2) "Hospital" means a person or governmental entity licensed in accordance with chapter |
2 | 17 of title 23 to establish, maintain, and operate a hospital. |
3 | (1)(3) "Insurer" means every nonprofit medical service corporation, hospital service |
4 | corporation, health maintenance organization, or other insurer offering and/or insuring health |
5 | services; the term shall in addition include any entity defined as an insurer under § 42-62-4; and . |
6 | (4) Physician" means a person with a license to practice allopathic or osteopathic medicine |
7 | in this state under the provisions of chapter 17 of title 23. |
8 | (2)(5) "Primary insurer" means the insurer primarily liable in accordance with the anti- |
9 | duplication provisions established by regulations promulgated by the director of business |
10 | regulation. |
11 | SECTION 3. Chapter 27-20.6 of the General Laws entitled "Health Care Insurers - |
12 | Coordination of Benefits" is hereby amended by adding thereto the following section: |
13 | 27-20.6-3.1. Continued board certification not to be considered in coordination of |
14 | benefits. |
15 | An insurer shall not: |
16 | (1) Deny reimbursement to a physician or hospital for services rendered because the |
17 | physician or any physicians within the hospital have not completed continued board certification. |
18 | (2) Provide lower reimbursement for services rendered by a physician or hospital because |
19 | the physician or any physicians within the hospital have not completed continued board |
20 | certification. |
21 | (3) Prohibit a physician or hospital from participating in any of the insurer’s provider |
22 | networks because the physician or any physicians within the hospital have not completed continued |
23 | board certification. |
24 | (4) Determine a contractual relationship with, or credentialing of, a physician or hospital |
25 | based upon the physician or any physician within the hospital’s completion or lack of completion |
26 | of continued board certification. |
27 | (5) Deny reimbursement to a physician or hospital for services rendered based upon which |
28 | continued board certification program or programs the physician or any physicians within the |
29 | hospital have completed. |
30 | (6) Provide lower reimbursement to a physician or hospital for services rendered based |
31 | upon which continued board certification program or programs the physician or any physicians |
32 | within the hospital have completed. |
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1 | SECTION 4. 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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1 | This act would prohibit the board of medical licensure and discipline from requiring |
2 | specialty board certification as a condition of licensure. This act would also provide that a health |
3 | care insurer would not deny reimbursement or provide lower reimbursement rates to a physician or |
4 | hospital, based on a physician’s decision whether or not to participate in a national continued board |
5 | certification program. |
6 | This act would take effect upon passage. |
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