§4303-G. Provider maintenance of certification requirements
(CONTAINS TEXT WITH VARYING EFFECTIVE DATES)
(WHOLE SECTION TEXT EFFECTIVE UNTIL 4/1/29)
(WHOLE SECTION TEXT REPEALED 4/1/29)
The following provisions govern maintenance of certification requirements.
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
1.
Definitions.
As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
A.
"Hospital" means a hospital licensed and operating under Title 22, chapter 404 or 405 or the parent of such institution, or a hospital subsidiary or hospital affiliate in this State that provides medical services or medically related diagnostic and laboratory services or engages in ancillary activities supporting those services.
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
B.
"Maintenance of certification program" means satisfactory participation in a program beyond the continuing medical education requirements currently in place by the Board of Licensure in Medicine or Board of Osteopathic Licensure, or initial board certification by a national or regional medical specialty board.
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
C.
"Outpatient clinical practice" means any medical practice, home care or hospice organization or other nonhospital entity providing medical care through physicians.
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
D.
"Physician" means an individual licensed under Title 32, chapter 36 or 48.
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
2.
Discrimination prohibited.
A carrier offering a health plan in this State may not:
A.
Deny reimbursement to a physician, hospital or outpatient clinical practice for services rendered because a physician does not participate in a maintenance of certification program;
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
B.
Provide lower reimbursement for services rendered by a physician, hospital or outpatient clinical practice because a physician does not participate in a maintenance of certification program;
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
C.
Prohibit a physician, hospital or outpatient clinical practice from participating in any of the carrier's provider networks because a physician does not participate in a maintenance of certification program; or
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
D.
Determine credentialing of a physician, hospital or outpatient clinical practice based on the status of a physician's, hospital's or outpatient clinical practice's participation in a maintenance of certification program.
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
3.
Repeal.
This section is repealed April 1, 2029.
[PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
SECTION HISTORY
PL 2023, c. 40, §1 (NEW). PL 2023, c. 40, §2 (AFF).