Senate Bill #301 (2019)

AN ACT RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE AND DISCIPLINE

Authorizes hospital medical staff to elect whether or not to participate in a maintenance of certification program, to elect medical specialty board to implement the program and prohibits insurers from denying reimbursement based solely on this election.

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Changes since original draft

  • 2019 – S 0301
  • 2019 – S 0301 SUBSTITUTE A
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  • LC001022
  • LC001022/SUB A
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  • S T A T E O F R H O D E I S L A N D
  • IN GENERAL ASSEMBLY
  • JANUARY SESSION, A.D. 2019
  • ____________
  • A N A C T
  • RELATING TO BUSINESSES AND PROFESSIONS – BOARD OF MEDICAL LICENSURE
  • AND DISCIPLINE
  • S TATE OF RHODE IS L AND
  • IN GENERAL ASSEMBLY
  • JANUARY SESSION, A.D. 2019
  • ____________
  • A N A C T
  • RELATINGTO BUSINESSESAND PROFESSIONS – BOARD OF MEDICAL LICENSURE
  • AND DISCIPLINE
  • Introduced By: Senators Sheehan, Crowley, Nesselbush, Metts, and Picard
  • Date Introduced: February 13, 2019
  • Referred To: Senate 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. Election as to participation in maintenance of effort programs.
  • (a) Definitions. As used in this section:
  • (1) "Hospital" has the same meaning as defined in § 23-17-2.
  • (2) "Maintenance of certification" means a continuous professional development program through which physicians are certified by one or more of the nationally recognized medical specialty boards. Maintenance of certification is separate from and in addition to any recertification and continuing medical education requirements required pursuant to § 5-37-2.1.
  • (3) "Physician" has the same meaning as defined in § 23-17-2.
  • (b) Maintenance of certification by hospital physicians.
  • (1) The medical staff (the staff) at any hospital shall decide by majority vote whether to require the staff to participate in a maintenance of certification program or programs. A hospital shall not impose a requirement that the staff participate in a maintenance of certification program without an affirmative vote by the staff to do so as provided by this section. No maintenance of certification program requirements shall be enforced at any hospital unless the staff affirmatively votes to impose such requirements.
  • (2) In the event the staff elects to participate in a maintenance of certification program, the staff shall also decide by majority vote, which medical specialty board the staff shall utilize to implement the maintenance of certification program.
  • (3) A vote whereby the staff affirmatively agrees to participate in a maintenance of certification program shall remain in effect for a period of time as determined by a majority vote of the staff, and shall be binding upon any physician who is or who seeks to become a staff member or have admitting privileges at the hospital at any time while the certification program is in effect.
  • SECTION 2. 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. Maintenance of certification not to be considered in coordination of benefits.
  • A health care insurer shall not deny reimbursement or discriminate in reimbursement rates to a physician or hospital, nor prevent a physician or hospital from participating in any of the insurer's provider networks, based solely on a physician's decision not to participate in any form of maintenance of certification, or a decision made by a hospital's medical staff as to whether or not to participate in a maintenance certification program or, if there is an election to participate, then upon the particular medical specialty board that is chosen, pursuant to § 5-37- 2.2.
  • SECTION 3. This act shall take effect upon passage.
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  • LC001022
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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
  • ***
  • This act would authorize hospital medical staff to elect whether or not to participate in a maintenance of certification program. If the staff elects to participate in such a program, the staff would also elect the medical specialty board the staff would utilize to implement the maintenance of certification program. This act would also prohibit health care insurers from denying reimbursement to a physician or hospital based solely upon this election.
  • This act would take effect upon passage. ======== LC001022 ========
  • It is enacted by the GeneralAssembly as follows:
  • SECTION 1. Chapter 23-17 of the General Laws entitled "Licensing of Health-Care Facilities" is hereby amended by adding thereto the following section:
  • 23-17-53.1. Election as to participation in continued board certification programs.
  • Definitions. As used in this section:
  • (1) "Continued board certification" means an ongoing recertification program through which physicians are recertified by one or more of the national and/or regional medical boards, which includes but is not limited to one or more of the medical specialty boards of the American Board of Medical Specialties, the American Osteopathic Association, the National Board of Physicians and Surgeons, or any other board approved by a majority vote of a hospital medical staff. 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" has the same meaning as defined in § 23-17-2.
  • (3) "Physician" has the same meaning as defined in § 5-37-1.
  • (b) Continued board certification by hospital physicians:
  • If continued board certification is required of a physician in order to be credentialed at a given hospital, that hospital must accept a physician's chosen continued board certification program(s) as defined in subsection (a)(1) of this section.
  • SECTION 2. Chapter 5-37 of the GeneralLaws entitled "Board of MedicalLicensure 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 of medical licensing and discipline shall not, by order, rule, or other method, require a physician applicant or physician licensee under its jurisdiction to obtain or maintain a national and/or regional board certification that is not otherwise specifically required in this chapter before it issues a license or license renewalto that physician applicant or physician licensee under this chapter.
  • 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 health care insurer shall not deny reimbursement or discriminate in reimbursement rates to a physician or hospital, nor prevent a physician or hospital from participating in any of the insurer's provider networks, based on a physician's decision whether or not to participate in a national and/or regional continued board certification program pursuant to § 23-17-53.1. If a physician does participate in a national and/or regional continued board certification program, a health care insurer shall not deny reimbursement or discriminate in reimbursement rates based upon the particular program(s) that is chosen.
  • SECTION 4. This act shalltake effect upon passage.
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  • LC001022/SUB A
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  • LC001022/SUB A - Page 2of 3
  • EXPLANATION
  • BY THE LEGISLATIVE COUNCIL
  • OF
  • A N A C T
  • RELATINGTO BUSINESSESAND PROFESSIONS – BOARD OF MEDICAL LICENSURE
  • AND DISCIPLINE
  • ***
  • This act would provide that if a hospital requires continued board certification by a physician in order for that physician to be credentialed by the hospital that hospitalwould have to accept a national and/or regional continued board certification program or programs from those programs approved by a majority vote of a hospitalmedicalstaff. In addition, the act prohibits the board of medical licensing and discipline from requiring specialty board certification as a condition of licensure. This act also provides that a health care insurer would not deny reimbursement or discriminate in 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.
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  • LC001022/SUB A
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  • LC001022/SUB A - Page 3of 3

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