Chapter 207

2005 -- H 5414 SUBSTITUTE B AS AMENDED

Enacted 07/08/05

 

A N A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     

     Introduced By: Representative Peter F. Kilmartin

     Date Introduced: February 09, 2005

 

 

It is enacted by the General Assembly as follows:

 

     SECTION 1. Section 23-17-51 of the General Laws in Chapter 23-17 entitled "Licensing

of Health Care Facilities" is hereby amended to read as follows:

 

     23-17-51. Magnetic resonance imaging -- Quality assurance standards. -- Any

licensed health care facility performing a magnetic resonance imaging examination shall be

accredited by the American College of Radiology.

     (a) Except as otherwise provided in subsection (b) of this section, a magnetic resonance

imaging examination eligible for reimbursement under the provisions of any individual or group

health insurance contract, plan or policy delivered in this state shall be reimbursed only if the

facility at which the examination has been conducted and processed is accredited by either the

American College of Radiology (ACR) or an alternate nationally recognized accrediting

organization whose accreditation standards are substantially similar to and no less stringent than

current or subsequent ACR standards and have been reviewed and deemed adequate by the

department of health. All accreditation standards under this section, whether promulgated by the

ACR or an alternate nationally recognized accrediting organization, shall include, but shall not be

limited to, provisions for establishing the qualifications of the physician, standards for quality

control and routine performance monitoring by a medical physicist, qualifications of the

technologist including minimum standards of supervised clinical experience, personnel and

patient safety guidelines, and standards for initial and ongoing quality control using clinical

image review and quantitative testing.

     (b) Any facility conducting and processing magnetic resonance imaging examinations

which, as of the effective date of this section, is receiving reimbursement for such services by a

health insurer, health maintenance organization or health plan, but is not accredited pursuant to

subsection (a), shall file its application for accreditation within six (6) months of the effective date

of this section. Such accreditation shall be obtained within eighteen (18) months of the effective

date of this section. A facility which begins conducting and processing of magnetic resonance

imaging examinations after the effective date of this section shall file its application for

accreditation within six (6) months of the date of initiation of the magnetic resonance imaging

examinations. Such accreditation shall be obtained within eighteen (18) months of the date of the

initiation of the magnetic resonance imaging examinations. After such accreditation is obtained, a

facility conducting and processing magnetic resonance imaging examinations shall, at all times,

maintain accreditation with the appropriate accrediting body. Notwithstanding anything herein to

the contrary, any facility which has filed for accreditation pursuant to this subsection (b) and

which has not been refused accreditation or withdrawn its application, will be deemed

provisionally accredited for the eighteen (18) month period dating from the application filing

date. Provided, further, that notwithstanding any provision of the general laws or public laws to

the contrary, any facility conducting and processing magnetic resonance imaging examinations

shall conform to the standards of the appropriate accrediting body at all times, including during

the accreditation process and shall certify said conformance to any reimbursing health insurer,

health maintenance organization or health plan.

 

     SECTION 2. Section 27-18-53 of the General Laws in Chapter 27-18 entitled "Accident

and Sickness Insurance Policies" is hereby amended to read as follows:

 

     27-18-53. Magnetic Resonance Imaging -- Quality assurance standards. -- A

magnetic resonance imaging examination eligible for reimbursement under the provisions of any

individual or group health insurance contract, plan or policy delivered in this state shall be

reimbursed only if the provider at which the examination has been conducted and processed, and

the licensed physician interpreting the results of the magnetic resonance imaging examination are

both accredited by the American College of Radiology.

     (a) Except as otherwise provided in subsection (b) of this section, a magnetic resonance

imaging examination eligible for reimbursement under the provisions of any individual or group

health insurance contract, plan or policy delivered in this state shall be reimbursed only if the

facility at which the examination has been conducted and processed is accredited by either the

American College of Radiology (ACR) or an alternate nationally recognized accrediting

organization whose accreditation standards are substantially similar and no less stringent than

current or subsequent ACR standards and have been reviewed and deemed adequate by the

department of health. All accreditation standards under this section, whether promulgated by the

ACR or an alternate nationally recognized accrediting organization, shall include, but shall not be

limited to, provisions for establishing the qualifications of the physician, standards for quality

control and routine performance monitoring by a medical physicist, qualifications of the

technologist including minimum standards of supervised clinical experience, personnel and

patient safety guidelines, and standards for initial and ongoing quality control using clinical

image review and quantitative testing.

     (b) Any facility conducting and processing magnetic resonance imaging examinations

which, as of the effective date of this section, is receiving reimbursement for such services by a

health insurer, health maintenance organization or health plan, but is not accredited pursuant to

subsectiion (a), shall file its application for accreditation within six (6) months of the effective date

of this section. Such accreditation shall be obtained within eighteen (18) months of the effective

date of this section. A facility which begins conducting and processing, magnetic resonance

imaging examinations after the effective date of this section shall file its application for

accreditation within six (6) months of the date of initiation of the magnetic resonance imaging

examinations. Such accreditation shall be obtained within eighteen (18) months of the date of the

initiation of the magnetic resonance imaging examinations. After such accreditation is obtained, a

facility conducting and processing, magnetic resonance imaging examinations shall, at all times,

maintain accreditation with the appropriate accrediting body. Notwithstanding anything herein to

the contrary, any facility which has filed for accreditation pursuant to this subsection (b) and has

not been refused accreditation or withdrawn its application, will be deemed provisionally

accredited for the eighteen (18) month period dating from the application filing date. Provided,

further, that notwithstanding any provision of the general or public laws to the contrary, any

facility conducting and processing magnetic resonance imaging examinations shall conform to

the standards of the appropriate accrediting body at all times, including during said accreditation

process and shall certify said conformance to any reimbursing health insurer, health maintenance

organization, or health plan.

 

     SECTION 3. Section 27-19-46 of the General Laws in Chapter 27-19 entitled "Nonprofit

Hospital Service Corporations" is hereby amended to read as follows:

 

     27-19-46. Magnetic resonance imaging -- Quality assurance standards. -- A magnetic

resonance imaging examination eligible for reimbursement by a nonprofit hospital services

corporation licensed pursuant to this chapter is reimbursed only if the provider at which the

examination has been conducted and processed, and the licensed physician interpreting the results

of the magnetic resonance imaging examination are both accredited by the American College of

Radiology.

     (a) Except as otherwise provided in subsection (b) of this section, a magnetic resonance

imaging examination eligible for reimbursement under the provisions of any individual or group

health insurance contract, plan or policy delivered in this state shall be reimbursed only if the

facility at which the examination has been conducted and processed is accredited by either the

American College of Radiology (ACR) or an alternate nationally recognized accrediting

organization whose accreditation standards are substantially similar to and no less stringent than

current or subsequent ACR standards and have been reviewed and deemed adequate by the

department of health. All accreditation standards under this section, whether promulgated by the

ACR or an alternate nationally recognized accrediting organization, shall include, but shall not be

limited to, provisions for establishing the qualifications of the physician, standards for quality

control and routine performance monitoring by a medical physicist, qualifications of the

technologist including minimum standards of supervised clinical experience, personnel and

patient safety guidelines, and standards for initial and ongoing quality control using clinical

image review and quantitative testing.

     (b) Any facility conducting and processing magnetic resonance imaging examinations

which, as of the effective date of this section, is receiving reimbursement for such services by a

health insurer, health maintenance organization or health plan, but is not accredited pursuant to

subsection (a), shall file its application for accreditation within six (6) months of the effective date

of this section. Such accreditation shall be obtained within eighteen (18) months of the effective

date of this section. A facility which begins conducting and processing, of magnetic resonance

imaging examinations after the effective date of this section shall file its application for

accreditation within six (6) months of the date of initiation of the magnetic resonance imaging

examinations. Such accreditation shall be obtained within eighteen (18) months of the date of the

initiation of the magnetic resonance imaging examinations. After such accreditation is obtained, a

facility conducting and processing, of magnetic resonance imaging examinations shall, at all

times, maintain accreditation with the appropriate accrediting body. Notwithstanding anything

herein to the contrary, any facility which has filed for accreditation pursuant to this subsection (b)

and which has not been refused accreditation or withdrawn its application, will be deemed

provisionally accredited for the eighteen (18) month period dating from the application filing

date. Provided, further, that notwithstanding any provisions of the general or public laws to the

contrary, any facility conducting and processing magnetic resonance imaging examinations shall

conform to the standards of the appropriate accrediting body at all times, including during the

accreditation process and shall certify said conformance to any reimbursing health insurer, health

maintenance organization or health plan.

 

     SECTION 4. Section 27-20-41 of the General Laws in Chapter 27-20 entitled "Nonprofit

Medical Service Corporations" is hereby amended to read as follows:

 

     27-20-41. Magnetic resonance imaging -- Quality assurance standards. -- A magnetic

resonance imaging examination eligible for reimbursement by a nonprofit medical service

corporation licensed pursuant to this chapter is reimbursed only if the provider at which the

examination has been conducted and processed, and the licensed physician interpreting the results

of the magnetic resonance imaging examination, both meet state approved quality assurance

standards for taking, processing, and interpreting magnetic resonance imaging examinations. The

director of health has the authority to promulgate rules and regulations necessary to carry out the

provisions of this section. The rules and regulations are based upon the most current standards of

the American College of Radiology.

     (a) Except as otherwise provided in subsection (b) of this section, a magnetic resonance

imaging examination eligible for reimbursement under the provisions of any individual or group

health insurance contract, plan or policy delivered in this state shall be reimbursed only if the

facility at which the examination has been conducted and processed is accredited by either the

American College of Radiology (ACR) or an alternate nationally recognized accrediting

organization whose accreditation standards are substantially similar to and no less stringent than

current or subsequent ACR standards and have been reviewed and deemed adequate by the

department of health. All accreditation standards under this section, whether promulgated by the

ACR or an alternate nationally recognized accrediting organization, shall include, but shall not be

limited to, provisions for establishing the qualifications of the physician, standards for quality

control and routine performance monitoring by a medical physicist, qualifications of the

technologist including minimum standards of supervised clinical experience, personnel and

patient safety guidelines, and standards for initial and ongoing quality control using clinical

image review and quantitative testing.

     (b) Any facility conducting and processing magnetic resonance imaging examinations

which, as of the effective date of this section, is receiving reimbursement for such services by a

health insurer, health maintenance organization or health plan, but is not accredited pursuant to

subsection (a), shall file its application for accreditation within six (6) months of the effective date

of this section. Such accreditation shall be obtained within eighteen (18) months of the effective

date of this section. A facility which begins conducting and processing, of magnetic resonance

imaging examinations after the effective date of this section shall file its application for

accreditation within six (6) months of the date of initiation of the magnetic resonance imaging

examinations. Such accreditation shall be obtained within eighteen (18) months of the date of the

initiation of the magnetic resonance imaging examinations. After such accreditation is obtained, a

facility conducting and processing, magnetic resonance imaging examinations shall, at all times,

maintain accreditation with the appropriate accrediting body. Notwithstanding anything herein to

the contrary, any facility which has filed for accreditation pursuant to this subsection (b) and

which has not been refused accreditation or withdrawn its application, will be deemed

provisionally accredited for the eighteen (18) month period dating from the application filing

date. Provided, further, that notwithstanding any provisions of the general or public laws to the

contrary, any facility conducting and processing magnetic resonance imaging examinations shall

conform to the standards of the appropriate accrediting body at all times, including during the

accreditation process and shall certify said conformance to any reimbursing health insurer, health

maintenance organization or health plan.

 

     SECTION 5. Section 27-41-56 of the General Laws in Chapter 27-41 entitled "Health

Maintenance Organizations" is hereby amended to read as follows:

 

     27-41-56. Magnetic resonance imaging -- Quality assurance standards. -- A magnetic

resonance imaging examination eligible for reimbursement by a health maintenance organization

licensed pursuant to this chapter is reimbursed only if the provider at which the examination has

been conducted and processed, and the licensed physician interpreting the results of the magnetic

resonance imaging examination are both accredited by the American College of Radiology.

     (a) Except as otherwise provided in paragraph (b) of this section, a magnetic resonance

imaging examination eligible for reimbursement under the provisions of any individual or group

health insurance contract, plan or policy delivered in this state shall be reimbursed only if the

facility at which the examination has been conducted and processed is accredited by either the

American College of Radiology (ACR) or an alternate nationally recognized accrediting

organization whose accreditation standards are substantially similar to and no less stringent than

current or subsequent ACR standards and have been reviewed and deemed adequate by the

department of health. All accreditation standards under this section, whether promulgated by the

ACR or an alternate nationally recognized accrediting organization, shall include, but shall not be

limited to, provisions for establishing the qualifications of the physician, standards for quality

control and routine performance monitoring by a medical physicist, qualifications of the

technologist including minimum standards of supervised clinical experience, personnel and

patient safety guidelines, and standards for initial and ongoing quality control using clinical

image review and quantitative testing.

     (b) Any facility conducting and processing magnetic resonance imaging examinations

which, as of the effective date of this section, is receiving reimbursement for such services by a

health insurer, health maintenance organization or health plan, but is not accredited pursuant to

subsection (a), shall file its application for accreditation within six (6) months of the effective date

of this section. Such accreditation shall be obtained within eighteen (18) months of the effective

date of this section. A facility which begins conducting and processing, of magnetic resonance

imaging examinations after the effective date of this section shall file its application for

accreditation within six (6) months of the date of initiation of the magnetic resonance imaging

examinations. Such accreditation shall be obtained within eighteen (18) months of the date of the

initiation of the magnetic resonance imaging examinations. After such accreditation is obtained, a

facility conducting and processing, magnetic resonance imaging examinations shall, at all times,

maintain accreditation with the appropriate accrediting body. Notwithstanding anything herein to

the contrary, any facility which has filed for accreditation pursuant to this subsection (b) and

which has not been refused accreditation or withdrawn its application, will be deemed

provisionally accredited for the eighteen (18) month period dating from the application filing

date. Provided, further, that notwithstanding any provisions of the general or public laws to the

contrary, any facility conducting and processing magnetic resonance imaging examinations shall

conform to the standards of the appropriate accrediting body at all times, including during the

accreditation process and shall certify said conformance to any reimbursing health insurer, health

maintenance organization or health plan.

 

     SECTION 6. This act shall take effect on January 1, 2006.     

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LC01382/SUB B

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