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New York Governor Signs RNFA Reimbursement Bill

Published: January 6, 2016

A little less than a year ago, New York Senator Betty Little (R-45) and Assemblyman Charles D. Lavine (D-13) introduced legislation to require private payers in New York to provide reimbursement for registered nurse first assistants (RNFAs) certified in operating room nursing for surgical first assistant services, if the insurance policy otherwise provides reimbursement for surgical first assistant services. On December 11, 2015, Governor Andrew Cuomo signed S1233A, which had passed the Senate and Assembly in June 2015. The lawl takes effect 180 days after it becomes law, which is June 8, 2016.


2015 was not the first time RNFA reimbursement legislation was introduced in New York. Similar legislation was introduced in several previous legislative cycles dating to 2007. In addition, AORN members were pursuing earlier iterations of the legislation dating back to the early 2000s.

In the most recent cycle, 2013-14, the Senate bill, S3056, stalled in the Senate Finance Committee. However, the Assembly passed A2753 the day before the adjournment of the legislative session. Because of the late hour, and also because the Senate bill version stalled, A2753 was not brought up on the Senate Floor for vote in 2014.

After the 2013-14 session, several AORN members in New York, including Marlene Craden, Pat Gussey, Daniel Paul, Sharon Robinson, and Deborah Spratt, had conversations with legislators, staff, and other stakeholders about the bill’s intent and real-life applicability. In response, Senator Little’s office convened a meeting with key staff members from the Senate Finance Committee to ensure all questions and concerns raised in 2014 were addressed, and AORN government affairs staff continued conversations with the Senate and Assembly sponsors’ staff in preparation for the 2015-16 legislative cycle.

2015-16 Legislative Cycle

The 2015-16 bills requiring private payers in New York to provide reimbursement RNFAs, S1233 and A1241, were introduced early in 2015, moved smoothly through the Senate Insurance and Finance Committees early in the session, and movement was seen in the Assembly in early spring. AORN member advocates, government affairs staff, and the bill sponsors’ staff were readily available to address a questions as they arose in the late spring around the legislation. On May 20, 2015, the bill passed the Senate unanimously and was sent over to the Assembly. The Assembly made a small change to the bill and passed it on June 17, 2015.

Over the summer AORN members and other nursing organizations such as ANA New York (ANA-NY) and the New York Organization of Nurse Executives & Leaders (NYONEL) sent letters to Governor Cuomo requesting that he sign S1233A. In the fall, AORN members sent additional letters detailing how the lack of reimbursement impacted their lives and patient care. The letters from nurses, even non-RNFAs, proved to be extremely vital when in mid-November AORN learned of some concerns with the legislation. AORN worked with members and Senator Little’s office, who convened a meeting with the concerned stakeholders. After many conversations and collaboration, the bill sponsors, AORN, and concerned stakeholders agreed upon needed technical changes, persuading Governor Cuomo to sign the bill and issue an approval memo explaining that he expects to see technical changes in 2016. The forthcoming changes do not impact the intent of the legislation that passed; they reflect changes to language that are more consistent with existing New York insurance code.

“Strategy, persistence, strong relationships with legislators, hard work from AORN members, and support from the nursing community were essential in ensuring S1233A not only passed but was signed by the Governor,” said Danielle Glover, AORN Legal and Government Affairs Manager. “The legislative process can be difficult and time consuming, but the voices of nurse constituents are extremely important in good policymaking. Congratulations to all New York RNFAs and especially to our primary bill champion, Marlene Craden.”

New York joins 16 other states that currently require reimbursement parity for RNFAs: Colorado, Florida, Georgia, Illinois, Kentucky, Louisiana, Maine, Maryland, Minnesota, Montana, New Jersey, Oregon, Rhode Island, Texas, Washington, and West Virginia.

What Does This Mean for You?

It is important for perioperative nurse leaders to be aware of legislative and regulatory trends nationally and in their states because policies affecting the surgical environment, including workplace safety, staffing, education, continued competency, and professional practice, are introduced on a regular basis. Perioperative nurse leaders have the opportunity to influence these policies as they are proposed and can start to prepare early for changes that may be required with new laws or rules.

When you see legislative action alerts from AORN Government Affairs, please take a few minutes to complete the requested action because constituent input is vital to passing and signing bills, as was evident with New York’s RNFA reimbursement bill. The support from all perioperative nurses and the nursing community as a whole was needed.

Each year AORN’s government affairs department monitors hundreds of bills and regulations related to nursing and patient safety. In fact, AORN was active in at least 18 states during 2015. AORN 2016 legislative priorities focus on six key areas: RN as Circulator, Registered Nurse First Assistants, Workplace Safety, Patient Safety Culture, Professional Practice, and Health Systems Improvement.

If you are interested in becoming involved with legislative efforts in your state, please contact Danielle Glover, AORN Legal and Government Affairs Manager.

Related Resouces

Advocacy 101 Handbook