An Act To Allow Certified Registered Nurse Anesthetists To Bill for Their Services
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 24 MRSA §2332-K, as amended by PL 2003, c. 517, Pt. B, §8, is further amended to read:
§ 2332-K. Coverage for services of certified nurse practitioners; certified nurse midwives; certified registered nurse anesthetists
1. Required coverage for services upon referral of primary care provider. A nonprofit hospital or a medical service organization that issues individual and group health care contracts shall provide coverage under those contracts for services performed by a certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist to a patient who is referred to the certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist by a primary care provider when those services are within the lawful scope of practice of the certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist.
2. Required coverage for self-referred services. With respect to individual and group health care contracts that do not require the selection of a primary care provider, a nonprofit hospital or medical service organization shall provide coverage under those contracts for services performed by a certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist when those services are covered services and when they are within the lawful scope of practice of the certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist.
3. Limits; coinsurance; deductibles. Any contract that provides coverage for services under this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
4. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
Sec. 2. 24-A MRSA §2757, as reallocated by RR 1999, c. 1, §32, is amended to read:
§ 2757. Coverage for services of certified nurse practitioners; certified nurse midwives; certified registered nurse anesthetists
1. Required coverage for services upon referral of primary care provider. An insurer that issues individual health insurance policies and contracts shall provide coverage under those contracts for services performed by a certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist to a patient who is referred to the certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist by a primary care provider when those services are within the lawful scope of practice of the certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist.
2. Required coverage for self-referred services. With respect to individual health insurance policies and contracts that do not require the selection of a primary care provider, an insurer shall provide coverage under those contracts for services performed by a certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist when those services are covered services and when they are within the lawful scope of practice of the certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist.
3. Limits; coinsurance; deductibles. Any contract that provides coverage for services under this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
Sec. 3. 24-A MRSA §2847-H, as amended by PL 2003, c. 517, Pt. B, §19, is further amended to read:
§ 2847-H. Coverage for services of certified nurse practitioners; certified nurse midwives; certified registered nurse anesthetists
1. Required coverage for services upon referral of primary care provider. An insurer that issues group health insurance policies and contracts shall provide coverage under those contracts for services performed by a certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist to a patient who is referred to the certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist by a primary care provider when those services are within the lawful scope of practice of the certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist.
2. Required coverage for self-referred services. With respect to group health insurance policies and contracts that do not require the selection of a primary care provider, an insurer shall provide coverage under those contracts for services performed by a certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist when those services are covered services and when they are within the lawful scope of practice of the certified nurse practitioner or , certified nurse midwife or certified registered nurse anesthetist.
3. Limits; coinsurance; deductibles. Any contract that provides coverage for services under this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
4. Application. The requirements of this section apply to all group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
Sec. 4. 24-A MRSA §4248, as amended by PL 2003, c. 517, Pt. B, §28, is further amended to read:
§ 4248. Coverage for services of certified nurse practitioners; certified nurse midwives; certified registered nurse anesthetists
1. Required coverage for services upon referral of primary care provider. A health maintenance organization that issues individual and group health care contracts shall provide coverage under those contracts for services performed by a participating certified nurse practitioner or , participating certified nurse midwife or participating certified registered nurse anesthetist to a patient who is referred to the participating certified nurse practitioner or , participating certified nurse midwife or participating certified registered nurse anesthetist by a primary care provider when those services are within the lawful scope of practice of the participating certified nurse practitioner or , participating certified nurse midwife or participating certified registered nurse anesthetist.
2. Required coverage for self-referred services. With respect to individual and group health care contracts that do not require the selection of a primary care provider, a health maintenance organization shall provide coverage under those contracts for services performed by a participating certified nurse practitioner or , participating certified nurse midwife or participating certified registered nurse anesthetist when those services are covered services and when they are within the lawful scope of practice of the participating certified nurse practitioner or , participating certified nurse midwife or participating certified registered nurse anesthetist.
3. Limits; coinsurance; deductibles. Any contract that provides coverage for services under this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
4. Application. The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
Sec. 5. Application. The requirements of this Act apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2020. For purposes of this Act, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
summary
This bill requires insurers, health maintenance organizations and nonprofit hospitals or medical service organizations to provide coverage for the services of certified registered nurse anesthetists provided to individuals.