Citations Affected:
IC 27-8-6-6
;
IC 27-13-36.2-7.
Synopsis: Reimbursement of nonphysician certified surgical
assistants. Requires health insurance policies and HMO contracts to
provide coverage for intraoperative surgical care services provided by
a physician or a nonphysician certified surgical assistant.
Effective: July 1, 2003.
January 9, 2003, read first time and referred to Committee on Health and Provider
Services.
A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
SECTION 1.
IC 27-8-6-6
IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2003]: Sec. 6. (a) As used in this section, "assistant to the
surgeon" means:
(1) a physician (as defined in
IC 25-27.5-2-9
);
(2) a physician assistant (as defined in
IC 25-27.5-2-10
);
(3) an advanced practice nurse (as defined in
IC 25-23-1-1
);
and
(4) a nonphysician certified surgical assistant.
(b) As used in this section, "nonphysician certified surgical
assistant" means a certified surgical assistant, a certified surgical
technologist/certified first assistant, or a registered nurse first
assistant who:
(1) is supervised by a physician licensed under IC 25-22.5;
(2) provides intraoperative surgical care; and
(3) is certified by one (1) of the following:
(A) The National Surgical Assistant Association on the
Certification of Surgical Assistants.
(B) The Liaison Council on Certification of Surgical
Technologists.
(C) The National Certification Board of Perioperative
Nursing.
(D) Any other national certifying body approved by the
medical licensing board.
(c) As used in this section, "intraoperative surgical care" means
assistance provided to an operating physician during an operative
procedure. The term includes the following:
(1) Positioning the patient.
(2) Preparing and draping the patient for an operative
procedure.
(3) Observing the operative site during the operative
procedure.
(4) Assisting in closing incisions or dressing wounds.
(5) Providing the best possible exposure of the anatomy
involved in the operative procedure.
(6) Performing any task that is:
(A) relevant to the operative procedure; and
(B) required by the operating physician.
(d) A policy of accident and sickness insurance (as defined in
IC 27-8-5-1
) that is issued on an individual or a group basis must
provide reimbursement to an insured for intraoperative surgical
care services provided by a surgeon. The policy must also provide
reimbursement for the intraoperative surgical care services
provided by an assistant to the surgeon if required by a surgeon.
(e) This section does not require coverage under a policy of
accident and sickness insurance for a service that is not otherwise
covered under the terms of the policy.
(f) This section does not require a person or an entity that
provides surgical services described in this section to employ or
utilize an assistant to the surgeon.
SECTION 2.
IC 27-13-36.2-7
IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2003]: Sec. 7. (a) As used in this section,
"assistant to the surgeon" means:
(1) a physician (as defined in
IC 25-27.5-2-9
);
(2) a physician assistant (as defined in
IC 25-27.5-2-10
);
(3) an advanced practice nurse (as defined in
IC 25-23-1-1
);
and
(4) a nonphysician certified surgical assistant.
(b) As used in this section, "nonphysician certified surgical
assistant" means a certified surgical assistant, a certified surgical
technologist/certified first assistant, or a registered nurse first
assistant who:
(1) is supervised by a physician licensed under IC 25-22.5;
(2) provides intraoperative surgical care; and
(3) is certified by one (1) of the following:
(A) The National Surgical Assistant Association on the
Certification of Surgical Assistants.
(B) The Liaison Council on Certification of Surgical
Technologists.
(C) The National Certification Board of Perioperative
Nursing.
(D) Any other national certifying body approved by the
medical licensing board.
(c) As used in this section, "intraoperative surgical care" means
assistance provided to an operating physician during an operative
procedure. The term includes the following:
(1) Positioning the patient.
(2) Preparing and draping the patient for an operative
procedure.
(3) Observing the operative site during the operative
procedure.
(4) Assisting in closing incisions or dressing wounds.
(5) Providing the best possible exposure of the anatomy
involved in the operative procedure.
(6) Performing any task that is:
(A) relevant to the operative procedure; and
(B) required by the operating physician.
(d) An individual contract or group contract
must provide
payment for intraoperative surgical care services provided by a
surgeon. The contract must also provide payment for the
intraoperative surgical care services provided by an assistant to the
surgeon if required by a surgeon.
(e) This section does not require coverage under an individual
contract or a group contract for a health care service that is not
otherwise covered under the terms of the contract.
(f) This section does not require a person or an entity that
provides surgical services described in this section to employ or
utilize an assistant to the surgeon.
SECTION 3. [EFFECTIVE JULY 1, 2003]
IC 27-8-6-6
, as added
by this act, applies only to accident and sickness insurance policies
that are issued, delivered, executed, amended, or renewed after
June 30, 2003.
SECTION 4. [EFFECTIVE JULY 1, 2003]
IC 27-13-36.2-7
, as
added by this act, applies only to health maintenance organization
contracts that are entered into, delivered, executed, amended, or
renewed after June 30, 2003.