Requires reimbursement for surgical first assistant services

Section 2 amends subsection (k) of section 3221 of the insurance law to provide for coverage for a licensed person qualified by experience and training who performs surgical first assistant services within his or her scope of practice in every policy of insurance in instances in which reimbursement for surgical first assistant services is provided.

Section 3 amends subparagraphs (G) and (H) of paragraph 4 of subsection (f) of section 4235 and adds a new subparagraph (I) to include any surgical first assistant services provided by a licensed person qualified by experience and training who performs such services within his or her scope of practice for a licensed person qualified by experience and training who performs surgical first assistant services within his or her scope of practice.

Section 4 adds a new subsection (ff) to section 4303 of the insurance law to require that every contract issued by a health service corporation or a medical expense indemnity corporation which provides for reimbursement for surgical first assistant services shall provide for coverage for a licensed person qualified by experience and training who performs surgical first assistant services within his or her scope of practice.

Section 5 amends subdivision 2 of section 365-a of the social services law by adding a new paragraph (q) to include care and services for surgical first assistant services for a licensed person qualified by experience and training who performs surgical first assistant services within his or her scope of practice.

Section 6 amends subparagraphs (xv) and (xvi) of paragraph (e) of subdivision 1 of section 369-ee of the social services law and adds a new subparagraph (xvii) to include surgical first assistant services performed by a licensed person qualified by experience and training who performs surgical first assistant services within his or her scope of practice.

Section 7 amends the opening paragraph of subdivision (a) of section 13 of the workers' compensation law to include all surgical services covered by this article, including coverage for surgical first assistant services, shall include care and services furnished in all covered settings provided by a licensed person qualified by experience and training who performs surgical first assistant services within his or her scope of practice.

Section 8 sets the effective date.

Justification

Registered professional nurses are authorized to diagnose and treat patients through such services as case-finding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being. The registered nurse first assistant is a registered professional nurse who provides supportive and restorative patient care by performing as a first assistant at surgery under the direction of a licensed physician or legally authorized licensed health care provider under State Education Law and in accordance with scope of practice qualifications.

The extraordinary capabilities of those nurses providing such services and their invaluable contributions to New York's health care delivery system are a matter of fact. These learned professionals work predominantly in sensitive pre-operative, intra-operative and postoperative environments and are a vital liaison between surgeon and patient. The diminishment of surgical resident availability has enhanced the need for the registered nurse first assistant to function as a vital link in the provision of quality patient care.

Typically, first assistant at surgery services are routinely reimbursed by health insurers for the services of other non physician, licensed professionals, who, within their scope of practice, perform, as first assistants at surgery. However, the first assistant at surgery services provided by the qualified registered nurse are not routinely reimbursed by insurers.

This bill will rectify that disparity. It will ensure that first assistant at surgery services, provided by a registered nurse first assistant, will be routinely reimbursed by insurers. This bill ensures the equitability of the provision and distribution of reimbursement for services already designated as reimbursable.

As a matter of fact, this bill describes a cost-effective approach since the reimbursement for a non-physician, licensed professional who functions as a first assistant is already established as a cost saving measure. Additionally, this bill also serves as an incentive for retention and recruitment of nursing professionals.

Legislative history

2008: S.5367-A Insurance; A.7894 Insurance

Effective date

This act shall take effect on the one hundred and eightieth day after it shall have become law and shall apply to all policies and contracts issued, renewed, modified, altered or amended after such a date.