Requires reimbursement for surgical first assistant services

Section 2 Amends subsection (k) of section 3221 of the insurance law by removing language related to the non-physician first assistant employment by a physician and billing for such services by a physician. It also eliminates a provision that allowed the insurer, in their sole discretion, to provide a global or capitated payment or electing to reimburse a non-physician first assistant directly for such services.

Section 3 Amends subsection (pp) to section 4303 of the insurance law by including hospital service corporations and by eliminating a provision that allowed the insurer, in their sole discretion, to provide a global or capitated payment or electing to reimburse a non-physician first assistant directly for such services.

Section 4 Amends subdivision 2 of section 365-a of the social services law by making technical changes. Additionally, while this section continues to allow the insurer to provide a global or capitated payment or elect to reimburse a non-physician first assistant directly for such services, the insurer is no longer able to make that decision in their sole discretion, but rather, as otherwise permitted by law.

Section 5 Repeals language added by chapter 536 of 2015 to the opening paragraph of subdivision (a) of section 13 of the workers' compensation law.

Section 6 Effective date.

Justification

The registered nurse first assistant is a registered professional nurse who provides supportive and restorative patient care by performing as a non-physician first assistant at surgery under the direction of a licensed physician or legally authorized licensed healthcare provider under State Education Law and in accordance with scope of practice qualifications.

Typically, non-physician first assistants, who are not registered nurses but are, licensed professionals, who, within their scope of

practice are providing non-physician first assistant surgical services, are routinely reimbursed by health insurers.

This bill would clarify the requirement to reimburse non-physician first assistant services provided by a Registered Nurse who is certified in operating room nursing; the services are within the scope of practice for non-physician first assistant; and the terms and conditions of the policy otherwise provide coverage for the services.

Legislative history

Amends S. 1233-A Signed 12/11/15 Chapter 536 2014 S. 3056-A reported to Finance; A.2753A passed Assembly 2013 S. 3056 reported to Finance; A. 2753 Ways and Means; 2012 S. 4138-B Amended and recommitted to insurance; A. 4138 referred to insurance 2011: S. 4138 Committed to Rules.

Fiscal implications

Undetermined

Effective date

This act shall take effect on the same date and in the same manner as a chapter of the laws of 2015 amending the insurance law, the social services law and the workers' compensation law relating to reimbursement for surgical first assistant services, as proposed in legislative bills numbers S.1233-A and A.1241-A, takes effect.