Rhode Island § 27-41-56 - Health Maintenance Organizations

§ 27-41-56. Magnetic resonance imaging — Quality assurance standards.

(a) Except as otherwise provided in subsection (b) of this section, a magnetic resonance imaging examination eligible for reimbursement under the provisions of any individual or group health insurance contract, plan, or policy delivered in this state shall be reimbursed only if the facility at which the examination has been conducted and processed is accredited by either the American College of Radiology (ACR), the Intersocietal Accreditation Commission (IAC), or an alternate nationally recognized accrediting organization whose accreditation standards are substantially similar to and no less stringent than current or subsequent ACR or IAC standards and have been reviewed and deemed adequate by the department of health. All accreditation standards under this section, whether promulgated by the ACR, IAC, or an alternate nationally recognized accrediting organization, shall include, but shall not be limited to: provisions for establishing the qualifications of the physician; standards for quality control and routine performance monitoring by a medical physicist; qualifications of the technologist, including minimum standards of supervised clinical experience; personnel and patient safety guidelines; and standards for initial and ongoing quality control using clinical image review and quantitative testing.

(b) Any facility conducting and processing magnetic resonance imaging examinations that, as of June 30, 2006, is receiving reimbursement for these services by a health insurer, health maintenance organization, or health plan, but is not accredited pursuant to subsection (a), shall file its application for accreditation within eighteen (18) months of June 28, 2007. The accreditation shall be obtained not later than twelve (12) months after submission of its application. A facility that begins conducting and processing, of magnetic resonance imaging examinations after June 30, 2006, shall file its application for accreditation within twelve (12) months of the date of initiation of the magnetic resonance imaging examinations. The accreditation shall be obtained not later than twelve (12) months after submission of its application. After the accreditation is obtained, a facility conducting and processing magnetic resonance imaging examinations shall, at all times, maintain accreditation with the appropriate accrediting body. Notwithstanding anything herein to the contrary, any facility that has filed for accreditation pursuant to this subsection (b) and that has not been refused accreditation or withdrawn its application, will be deemed provisionally accredited for the twelve-month (12) period dating from the application filing date. Provided, further, that notwithstanding any provisions of the general or public laws to the contrary, any facility conducting and processing magnetic resonance imaging examinations shall conform to the standards of the appropriate accrediting body at all times, including during the accreditation process, and shall certify conformance to any reimbursing health insurer, health maintenance organization, or health plan.