Section 4320-Q - Coverage for services provided by a certified registered nurse anesthetist1.Services provided by a certified registered nurse anesthetist. A carrier offering a health plan in this State shall provide coverage for health care services performed by a certified registered nurse anesthetist licensed under Title 32, chapter 31 when those services are covered services under the health plan when performed by any other health care provider and when those services are within the lawful scope of practice of the certified registered nurse anesthetist. [2021, c. 39, §1(NEW); RR 2021, c. 1, Pt. A, §23(RAL).]
2.Limits; deductible; copayment; coinsurance. A carrier may offer a health plan containing a provision for a deductible, copayment or coinsurance requirement for a health care service provided by a certified registered nurse anesthetist as long as the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to the same service provided by other health care providers. [2021, c. 39, §1(NEW); RR 2021, c. 1, Pt. A, §23(RAL).]
3.Network participation. A carrier may not prohibit a certified registered nurse anesthetist from participating in the carrier's provider network or billing the carrier directly solely because the provider is a certified registered nurse anesthetist as long as the provider is willing to meet the same terms and conditions as other participating providers. This subsection does not require a carrier to contract with all certified registered nurse anesthetists or require a carrier to provide coverage under a health plan for any service provided by a participating certified registered nurse anesthetist that is not a covered service under the plan. [2021, c. 39, §1(NEW); RR 2021, c. 1, Pt. A, §23(RAL).]
4.Claim submission. Services billed by a certified registered nurse anesthetist must be submitted using the current standardized claim form for professional services approved by the Federal Government and submitted electronically. [2021, c. 39, §1(NEW); RR 2021, c. 1, Pt. A, §23(RAL).]
Added by 2021, c. 39,§ 1, eff. 6/29/2021.Reallocated from 4320-P to correct a numbering problem created by Public Law 2021, chapters 28 and 39, which enacted 2 substantively different provisions with the same section number.