Bill > S2938

This bill aims to improve patient access to care by ensuring equitable reimbursement for services provided by both physicians and certified registered nurse anesthetists (CRNAs), who are registered nurses authorized to practice in an advanced role. The core provision is that insurance plans and government programs, including those for state employees and Medicaid, cannot discriminate in terms of participation, coverage, or payment between physicians and CRNAs when they are acting within their licensed scope of practice. While different reimbursement rates can be established based on quality or performance measures, these measures must be applied equally to both professions. The bill mandates that claims identify the National Provider Identifier (NPI) of the provider and requires that CRNAs be reimbursed at least the same amount as a physician would be for the same service, without reducing physician reimbursement to achieve this. It also clarifies that in situations where a law or rule requires physician involvement for anesthesia services reimbursement, a CRNA can fulfill that requirement. The Commissioner of Insurance is tasked with creating regulations to implement and enforce these changes across various insurance types, including individual and group accident and sickness policies, hospital service plans, medical service corporations, health maintenance organizations, and preferred provider contracts.

Joint Committee on Health Care Financing (Joint)

https://malegislature.gov/Bills/194/S2938