Senate Bill No. 81
(By Senator Hunter)
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[Introduced January 9, 2008; referred to the Committee on Banking
and Insurance.]
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A BILL to amend and reenact §33-15-4b of the Code of West Virginia,
1931, as amended, relating to prohibiting insurers offering
coverage for nursing services from limiting the definition of
"scope of practice" for purposes of benefit determination.
Be it enacted by the Legislature of West Virginia:
That §33-15-4b of the Code of West Virginia, 1931, as amended,
be amended and reenacted to read as follows:
ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE.
§33-15-4b. Policies to cover nursing services; definition.
(a) Any insurer who, on or after the first day of January, one
thousand nine hundred eighty-four, delivers or issues a policy of
accident and sickness insurance in this state under the provisions
of this article shall make available as benefits to all subscribers
and members coverage for primary health care nursing services as
hereinafter set forth if such services are currently being reimbursed when rendered by any other duly licensed health care
practitioner. No insurer may be required to pay for duplicative
health care services actually provided by both a registered
professional nurse or licensed midwife and other health providers.
(b) For purposes of this section, section three-e, article
sixteen and section seven-a, article twenty-four of this chapter,
"primary health care nursing services" includes nursing care
rendered by a nonsalaried duly licensed registered professional
nurse engaged in private nursing practice or partnership with other
health care providers within the lawful scope of practice as
defined in section one, article seven, chapter thirty of this code,
and care rendered by a licensed nurse-midwife or midwife as the
occupation is defined in section one, article fifteen, chapter
thirty of this code, and which care is within the scope of duties
for such licensed nurse-midwife or midwife as permitted by the
provisions of section seven, article fifteen of said chapter
thirty.
(c) Nothing in this section may be construed to permit any
registered professional nurse licensee or midwife licensee to
perform professional services beyond
such the individual's areas of
professional competence as established by education, training and
experience.
(d) Nothing in this section may be construed to permit any
insurer providing benefits in accordance with this section to limit or restrict the scope of practice for licensed professional nurses
for purposes of benefit determination under any policy issued in
accordance with this section.
NOTE: The purpose of this bill is to prohibit insurers
offering nursing services coverage from limiting the definition of
scope of practice for purposes of benefit determination.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.