MISSISSIPPI LEGISLATURE

1999 Regular Session

To: Public Health and Welfare

By: Senator(s) Bean

AN ACT TO DIRECT THE PAYMENT BY THIRD PARTIES OF CERTIFIED NURSE PRACTITIONERS; TO AMEND SECTION 83-41-213, MISSISSIPPI CODE OF 1972, IN CONFORMITY THERETO; AND FOR RELATED PURPOSES.

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

SECTION 1. A policy or contract providing for third-party payment or prepayment of health or medical expenses shall include a provision for the payment of necessary medical or surgical care and treatment provided by a duly certified nurse practitioner and performed within the scope of the license of the certified nurse practitioner if the policy or contract would pay for the care and treatment if the care and treatment were provided by a person engaged in the practice of medicine and surgery or osteopathic medicine and surgery. The policy or contract shall provide that policyholders and subscribers under the policy or contract may reject the coverage for services which may be provided by a certified nurse practitioner if the coverage is rejected for all providers of similar services. A policy or contract subject to this section shall not impose a practice or supervision restriction which is inconsistent with or more restrictive than the restriction already imposed by law. This section applies to services provided under a policy or contract delivered, issued for delivery, continued, or renewed in this on or after July 1, 1999, and to an existing policy or contract, on the policy's or contract's anniversary or renewal date, whichever is later. This section does not apply to policyholders or subscribers eligible for coverage under Title XVIII of the federal Social Security Act or any similar coverage under a state or federal government plan. For the purposes of this section, third-party payment or prepayment includes an individual or group health care service contract, an individual or group health maintenance organization contract, or a preferred provider organization contract. Nothing in this section shall be interpreted to require an individual or group health maintenance organization, or a preferred provider organization to provide payment or prepayment for services provided by a certified nurse practitioner unless the certified nurse practitioner or the certified nurse practitioner's collaborating physician has entered into a contract or other agreement to provide services with the individual or group health maintenance organization or the preferred provider organization or arrangement.

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

83-41-213. (1) From and after January 1, 1999, whenever any policy of insurance or any medical service plan or hospital service contract or hospital and medical service contract issued, delivered, administered, continued or renewed in this state provides for reimbursement for any service which is within the lawful scope of practice of a duly certified nurse practitioner 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), 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 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 shall be entitled to participate in such policies, plans or contracts providing for the services of nurse practitioners 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). Reimbursement shall be based on services rendered by a duly certified nurse practitioner.

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 for the performance of authorized services by such practitioner.

(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 July 1, 1999.