(a) Every group health insurance contract, plan, or group policy delivered, issued for delivery or renewed in this state which provides medical coverage, and every group policy which provides for treatment of persons for the prevention, cure or correction of any illness or physical or mental condition, shall provide, as an optional rider, coverage for the services of a doctor of acupuncture as a provider of acupuncture services; provided, that this section shall not apply to insurance coverage providing benefits for: (1) hospital confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare supplement; (6) limited benefit health; (7) specified disease indemnity; (8) sickness or bodily injury or death by accident or both; and (9) other limited benefit policies.
Terms Used In Rhode Island General Laws 27-18-55
- Contract: A legal written agreement that becomes binding when signed.
- provider: means a health care professional or a health care facility. See Rhode Island General Laws 27-18-1.1.
(b) For the purposes of this section:
(1) “Doctor of acupuncture” means a practitioner licensed under chapter 37.2 of title 5.
(2) “Coverage for the services of a doctor of acupuncture as a provider of acupuncture services” means coverage for acupuncture as defined in § 5-37.2-2(1).
(c) It shall remain within the sole discretion of the accident and sickness insurer as to which doctor of acupuncture it shall contract with. Reimbursement shall be provided according to the respective principles and policies of the accident and sickness insurer; provided, that no accident and sickness insurer may be required to pay for duplicative services actually rendered by a doctor of acupuncture and any other health care provider. Nothing contained in this section shall preclude the accident and sickness insurer from conducting managed care, medical necessity or utilization review.
(P.L. 1999, ch. 288, § 1.)