House File 2184
HOUSE FILE
BY UPMEYER
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to third=party payor compensation of certified
2 registered nurse first assistants.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 5313HH 80
5 pf/cf/24
PAG LIN
1 1 Section 1. NEW SECTION. 249A.15A CERTIFIED REGISTERED
1 2 NURSE FIRST ASSISTANT == ELIGIBLE FOR PAYMENT.
1 3 1. The department shall adopt rules pursuant to chapter
1 4 17A entitling a certified registered nurse first assistant who
1 5 meets the requirements of this section and is acting within
1 6 the scope of practice of a certified registered nurse first
1 7 assistant to payment for services provided to recipients of
1 8 medical assistance.
1 9 2. To be eligible for reimbursement under this section as
1 10 a certified registered nurse first assistant, an individual
1 11 shall meet all of the following requirements:
1 12 a. Be currently licensed as a registered nurse pursuant to
1 13 chapter 152.
1 14 b. Be currently certified in perioperative nursing. For
1 15 the purpose of this paragraph, "perioperative nursing" means a
1 16 practice of nursing in which a registered nurse provides
1 17 preoperative, intraoperative, and postoperative nursing care
1 18 to surgical patients.
1 19 c. Hold a degree or certificate from and have successfully
1 20 completed a formal registered nurse first assistant program
1 21 approved by the department.
1 22 3. The department shall adopt rules establishing
1 23 reimbursement of certified registered nurse first assistants
1 24 at a rate which is a percentage of the surgeon's fee which may
1 25 be the percentage established under the Medicare program for
1 26 reimbursement of surgical first assisting services.
1 27 Sec. 2. Section 509.3, Code 2003, is amended by adding the
1 28 following new subsection:
1 29 NEW SUBSECTION. 8. A provision shall be made available to
1 30 policyholders, under group policies covering hospital,
1 31 medical, or surgical expenses for payment of necessary medical
1 32 or surgical care and treatment provided by a certified
1 33 registered nurse first assistant, if the care and treatment
1 34 are provided within the scope of the person's license and if
1 35 the policy would pay for the care and treatment if the care
2 1 and treatment were provided by a person practicing a health=
2 2 related profession required to be licensed or certified
2 3 pursuant to chapter 147 who is practicing within their scope
2 4 of practice. The policy shall provide that the policyholder
2 5 may reject the coverage or provision if the coverage or
2 6 provision for similar services which may be provided by a
2 7 certified registered nurse first assistant is rejected for all
2 8 providers of services required to be licensed or certified
2 9 pursuant to chapter 147 practicing within their scope of
2 10 practice. This subsection applies to all group policies
2 11 delivered or issued for delivery on or after July 1, 2004, and
2 12 to existing group policies on their next anniversary or
2 13 renewal date, or upon expiration of the applicable collective
2 14 bargaining contract, if any, whichever is later. This
2 15 subsection does not apply to blanket, short=term travel,
2 16 accident=only, limited or specified disease, or individual or
2 17 group conversion policies, or policies designed only for
2 18 issuance to persons for coverage under Title XVIII of the
2 19 federal Social Security Act, or any other similar coverage
2 20 under a state or federal government plan.
2 21 Sec. 3. Section 509.3, unnumbered paragraph 2, Code 2003,
2 22 is amended to read as follows:
2 23 In addition to the provisions required in subsections 1
2 24 through 7 8, the commissioner shall require provisions through
2 25 the adoption of rules implementing the federal Health
2 26 Insurance Portability and Accountability Act, Pub. L. No. 104=
2 27 191.
2 28 Sec. 4. Section 514B.1, subsection 5, Code 2003, is
2 29 amended by adding the following new paragraph:
2 30 NEW PARAGRAPH. e. The health care services available to
2 31 enrollees under prepaid group plans covering hospital,
2 32 medical, or surgical expenses shall include a provision for
2 33 payment of necessary medical or surgical care and treatment
2 34 provided by a certified registered nurse first assistant, if
2 35 the care and treatment are provided within the scope of the
3 1 person's license and the plan would pay for the care and
3 2 treatment if the care and treatment were provided by a person
3 3 practicing a health=related profession required to be licensed
3 4 or certified pursuant to chapter 147 who is practicing within
3 5 their scope of practice. The plan shall provide that the plan
3 6 enrollees may reject the coverage or provision if the coverage
3 7 or provision for similar services which may be provided by a
3 8 certified registered nurse first assistant is rejected for all
3 9 providers of services required to be licensed or certified
3 10 pursuant to chapter 147 practicing within their scope of
3 11 practice. This provision applies to services provided under
3 12 plans made on or after July 1, 2004, and to existing group
3 13 plans on their next anniversary or renewal date, or upon
3 14 expiration of the applicable collective bargaining contract,
3 15 if any, whichever is later. This paragraph does not apply to
3 16 enrollees eligible for coverage under Title XVIII of the
3 17 federal Social Security Act, or any other similar coverage
3 18 under a state or federal government plan.
3 19 EXPLANATION
3 20 This bill provides for third=party reimbursement for
3 21 services provided by certified registered nurse first
3 22 assistants (CRNFAs). The bill directs the department to adopt
3 23 rules pursuant to Code chapter 17A entitling a CRNFA who meets
3 24 specified requirements to payment for services provided to
3 25 recipients of medical assistance. The bill directs the
3 26 department to establish reimbursement of CRNFAs at a rate
3 27 which is a percentage of the surgeon's fee which may be the
3 28 percentage established under the Medicare program for
3 29 reimbursement of the surgical first assisting services.
3 30 The bill also requires group insurance policies and health
3 31 maintenance organization contracts to cover or include care
3 32 and treatment provided by a CRNFA if the policy or available
3 33 health care service currently covers or includes the care and
3 34 treatment if provided by a person practicing a health=related
3 35 profession required to be licensed or certified pursuant to
4 1 Code chapter 147 who is practicing within their scope of
4 2 practice. The bill also requires that the care or treatment
4 3 be within the scope of practice of the CRNFA. The requirement
4 4 applies to policies delivered and issued and services provided
4 5 under plans on or after July 1, 2004, and to existing policies
4 6 or plans on the latter of the anniversary, renewal, or
4 7 expiration of a collective bargaining contract.
4 8 LSB 5313HH 80
4 9 pf/cf/24