House Bill No. 539

Introduced By _______________________________________________________________________________

A Bill for an Act entitled: "An Act providing for the inclusion of advanced practice registered nurses as primary care providers; and providing an applicability date."

Be it enacted by the Legislature of the State of Montana:

NEW SECTION. Section 1.  Advanced practice registered nurses as primary care providers. (1) Each health benefit plan must include advanced practice registered nurses as primary care providers. The issuer of a health benefit plan shall contract with advanced practice registered nurses in an area in which advanced practice registered nurses are available and willing to be designated as primary care providers to ensure that covered persons have access without unreasonable delay. An advanced practice registered nurse may not be required to accept primary care provider status if the advanced practice registered nurse does not wish to be designated as a primary care provider. The issuer of a health benefit plan shall use similar criteria applicable to advanced practice registered nurses with regard to credentials and other selection criteria for a participating advanced practice registered nurse as are usually applied to other primary care providers who are participating in the health benefit plan.

(2) A health benefit plan must allow an advanced practice registered nurse to request participation as a primary care provider in the scope of the advanced practice registered nurse's practice and must provide at least one period annually during which an advanced practice registered nurse may request participation.

(3) Each health benefit plan must allow a covered person to select any participating advanced practice registered nurse of the covered person's choice as the covered person's primary care provider.

(4) For the purposes of this section, "health benefit plan" means any group or individual disability plan, policy, certificate of insurance, or membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state.

NEW SECTION. Section 2.  Advanced practice registered nurses as primary care providers. (1) Each health maintenance organization shall include advanced practice registered nurses as primary care providers. The health maintenance organization shall contract with advanced practice registered nurses in an area in which advanced practice registered nurses are available and willing to be designated as primary care providers to ensure that covered persons have access without unreasonable delay. An advanced practice registered nurse may not be required to accept primary care provider status if the advanced practice registered nurse does not wish to be designated as a primary care provider. A health maintenance organization shall use similar criteria applicable to advanced practice registered nurses with regard to credentials and other selection criteria for a participating advanced practice registered nurse as are usually applied by the health maintenance organization with respect to other primary care providers who are participating in the health maintenance organization.

(2) A health maintenance organization shall allow an advanced practice registered nurse to request participation as a primary care provider in the scope of the advanced practice registered nurse's practice and shall provide at least one period annually during which an advanced practice registered nurse may request participation.

(3) Each health maintenance organization shall allow a covered person to select any participating advanced practice registered nurse of the covered person's choice as the covered person's primary care provider.

NEW SECTION. Section 3.  Codification instruction. (1) [Section 1] is intended to be codified as an integral part of Title 33, chapter 22, and the provisions of Title 33, chapter 22, apply to [section 1].

(2) [Section 2] is intended to be codified as an integral part of Title 33, chapter 31, and the provisions of Title 33, chapter 31, apply to [section 2].

NEW SECTION. Section 4.  Applicability. [This act] applies to each health benefit plan that is issued, delivered, issued for delivery, or renewed in Montana on or after October 1, 1997.

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