MISSISSIPPI LEGISLATURE

1997 Regular Session

To: Public Health and Welfare

By: Senator(s) Canon

Senate Bill 2064

AN ACT TO CODIFY SECTION 73-15-39, MISSISSIPPI CODE OF 1972, TO PRESCRIBE QUALIFICATIONS FOR REGISTERED NURSES TO BE DESIGNATED AS "REGISTERED NURSE FIRST ASSISTANTS," TO REQUIRE HEALTH CARE INSTITUTIONS TO ESTABLISH PROCEDURES FOR GRANTING CLINICAL PRIVILEGES TO SUCH PERSONS AND TO PROVIDE FOR PAYMENT TO REGISTERED NURSE FIRST ASSISTANTS UNDER INSURANCE CONTRACTS THAT PROVIDE FOR SURGICAL FIRST ASSISTING BENEFITS OR SERVICES; TO AMEND SECTION 83-41-213, MISSISSIPPI CODE OF 1972, TO PROVIDE THE RIGHT OF AN INSURED TO BE REIMBURSED FOR SERVICES PERFORMED BY REGISTERED NURSE FIRST ASSISTANTS WITHIN THE LAWFUL SCOPE OF THEIR PRACTICE; AND FOR RELATED PURPOSES. 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. The following provision shall be codified as Section 73-15-39, Mississippi Code of 1972:

73-15-39. (1) The purposes of this section are to:

(a) Encourage the use of Registered Nurse First Assistants who meet the qualifications of this section as "assistants at surgery" by physicians and hospitals to provide quality, cost-effective surgical intervention to health care recipients of the state.

(b) Provide for reimbursement for the Registered Nurse First Assistant from managed health care agencies, state agencies, workers' compensation carriers and private insurance companies.

(2) As used in this section, the term:

(a) "Perioperative nursing" means a practice of nursing in which the nurse provides preoperative, intraoperative and postoperative nursing care to surgical patients.

(b) "Recognized program" means a program that:

(i) Addresses all content of the Association of Operating Room Nurses, Inc., "Core Curriculum for the Registered Nurse First Assistant"; and

(ii) Is equivalent to one (1) year of post-basic nursing study, and takes place in an institution approved by the appropriate regional accrediting body for higher education (colleges and universities); and

(iii) The structured didactic shall be equivalent to no less than one (1) semester (four (4) months in length), and the supervised clinical shall be equivalent to no less than one (1) semester (four (4) months in length); therefore, the total program is a total of one (1) year in length; and

(iv) Award a degree or certificate of Registered Nurse First Assistant (RNFA) status upon satisfactory completion of all requirements.

(c) "Registered Nurse First Assistant" or "RNFA" means a person who meets the qualifications listed in this section.

(3) A Registered Nurse First Assistant is any person who:

(a) Is licensed as a registered nurse;

(b) Is certified in perioperative nursing; and

(c) Holds a degree or certificate from and has successfully completed a recognized RNFA program.

(4) Each health care institution must establish specific procedures for the appointment and reappointment of Registered Nurse First Assistant staff members and for granting, renewing and revising their clinical privileges.

(5) Notwithstanding any other provision of law, when any health insurance policy, health care services plan or other contract provides for payment for surgical first assisting benefits or services, the policy, plan or contract is to be construed as providing for payment to a Registered Nurse First Assistant who performs such services that are within the scope of a Registered Nurse First Assistant's professional license.

SECTION 2. Section 83-41-213, Mississippi Code of 1972, is amended as follows:

83-41-213. (1) From and after January 1, 1997, whenever any policy of insurance or any medical service plan or hospital service contract or hospital and medical service contract issued in this state provides for reimbursement for any service which is within the lawful scope of practice of a duly certified nurse practitioner, or a Registered Nurse First Assistant, working under the supervision of a duly licensed physician as provided for by rules and regulations implemented by the Mississippi Board of Nursing under Section 73-15-5(2) et seq., the insured or other person entitled to benefits under such policy shall be entitled to reimbursement for such services, whether such services are performed by a duly licensed physician or by a duly certified nurse practitioner, or a Registered Nurse First Assistant, working under the supervision of a duly licensed physician, notwithstanding any provision to the contrary in any statute or in such policy, plan or contract. Duly certified nurse practitioners, or a Registered Nurse First Assistant, shall be entitled to participate in such policies, plans or contracts providing for the services of nurse practitioners, or a Registered Nurse First Assistant, working under the supervision of a duly licensed physician, as authorized by the rules and regulations implemented by the Mississippi Board of Nursing under Section 73-15-5(2) et seq. Reimbursement shall be based on services rendered by a duly certified nurse practitioner, or a Registered Nurse First Assistant.

It is the intent of the Legislature by this section to provide for expanded health delivery services and to provide for some reduction of the cost of medical services where possible; and any payments made hereunder shall either be in lieu of payments to physicians or payments to physicians shall be reduced by that amount paid to a nurse practitioner, or a Registered Nurse First Assistant, for the performance of authorized services by such practitioner.

It is further the intent of the Legislature to provide for the use of Registered Nurse First Assistants who meet the qualifications established for the Mississippi Board of Nursing as "assistants at surgery" by physicians and health care facilities to provide quality cost-effective surgical intervention to health care recipients in the state.

(2) Any action taken to prohibit nurses from practicing in a manner consistent with Section 73-15-1 et seq., including any limitation on clinical privileging or performing other activities consistent with standards of nursing practice, is prohibited. Any rules or regulations that impact the practice of nurse practitioners shall hereafter be jointly promulgated by the Mississippi Board of Nursing and the State Board of Medical Licensure.

SECTION 3. This act shall take effect and be in force from and after its passage.