2022 -- H 7394

========

LC004472

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

____________

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE

AND DISCIPLINE

     Introduced By: Representative Patricia A. Serpa

     Date Introduced: February 09, 2022

     Referred To: House Health & Human Services

     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. Prohibition of board certification requirement to practice medicine.

     Notwithstanding any provision of this chapter to the contrary, the board shall not require a

physician applicant or physician licensee under its jurisdiction to obtain or maintain a national or

regional board certification that is not otherwise specifically required in this chapter before it issues

a license or license renewal to that physician applicant or physician licensee under this chapter.

     SECTION 2. Section 27-20.6-1 of the General Laws in Chapter 27-20.6 entitled "Health

Care Insurers - Coordination of Benefits" is hereby amended to read as follows:

     27-20.6-1. Definitions.

     As used in this chapter, the following terms shall have the following meanings:

     (1) "Continued board certification" means an ongoing recertification program through

which physicians are recertified in their medical specialty by one or more of the national or regional

medical boards. Continued board certification is separate from and in addition to any recertification

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

     (2) "Hospital" means a person or governmental entity licensed in accordance with chapter

17 of title 23 to establish, maintain, and operate a hospital.

     (1)(3) "Insurer" means every nonprofit medical service corporation, hospital service

corporation, health maintenance organization, or other insurer offering and/or insuring health

services; the term shall in addition include any entity defined as an insurer under § 42-62-4; and

     (4) "Physician" means a person with a license to practice allopathic or osteopathic

medicine; and

     (2)(5) "Primary insurer" means the insurer primarily liable in accordance with the anti-

duplication provisions established by regulations promulgated by the director of business

regulation.

     SECTION 3. 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. Continued board certification not to be considered in coordination of

benefits.

     (a) An insurer shall not deny reimbursement to a physician or hospital for services rendered

because the physician or any physicians within the hospital have not completed continued board

certification.

     (b) An insurer shall not provide lower reimbursement for services rendered by a physician

or hospital because the physician or any physicians within the hospital have not completed

continued board certification.

     (c) An insurer shall not prohibit a physician or hospital from participating in any of the

insurer's provider networks because the physician or any physicians within the hospital have not

completed continued board certification.

     SECTION 4. This act shall take effect upon passage.

========

LC004472

========

LC004472 - Page 2 of 3

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE

AND DISCIPLINE

***

     This act would prohibit the board of medical licensure and discipline from requiring

specialty board certification as a condition of licensure. This act also provides that a health care

insurer shall not deny reimbursement or provide lower reimbursement rates to a physician or

hospital, based on a physician's decision whether or not to participate in a national continued board

certification program.

     This act would take effect upon passage.

========

LC004472

========

LC004472 - Page 3 of 3