Rhode Island § 27-41-57 - Health Maintenance Organizations

§ 27-41-57. Acupuncture services.

(a) Every group health insurance contract, plan, or group policy delivered, issued for delivery, or renewed in this state that provides medical coverage, and every group policy that 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.

(b) For the purposes of this section:

(1) “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).

(2) “Doctor of acupuncture” means a practitioner licensed under chapter 37.2 of title 5.

(c) It remains within the sole discretion of the health maintenance organization as to which doctor of acupuncture it contracts with. Reimbursement shall be provided according to the respective principles and policies of the health maintenance organization; provided, that no health maintenance organization is required to pay for duplicative services actually rendered by a doctor of acupuncture and any other healthcare provider. Nothing contained in this section precludes the health maintenance organization from conducting managed care, medical necessity, or utilization review.