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This entry was published on 2016-03-18
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SECTION 3217-C
Primary and preventive obstetric and gynecologic care
Insurance (ISC) CHAPTER 28, ARTICLE 32
§ 3217-c. Primary and preventive obstetric and gynecologic care. (a)
No insurer subject to this article shall by contract, written policy or
procedure limit a female insured's direct access to primary and
preventive obstetric and gynecologic services, including annual
examinations, care resulting from such annual examinations, and
treatment of acute gynecologic conditions, from a qualified provider of
such services of her choice from within the plan or for any care related
to a pregnancy, provided that: (1) such qualified provider discusses
such services and treatment plan with the insured's primary care
practitioner in accordance with the requirements of the insurer; and (2)
such qualified provider agrees to adhere to the insurer's policies and
procedures, including any applicable procedures regarding referrals and
obtaining prior authorization for services other than obstetric and
gynecologic services rendered by such qualified provider, and agrees to
provide services pursuant to a treatment plan (if any) approved by the
insurer.

(b) An insurer shall treat the provision of obstetric and gynecologic
care, and the ordering of related obstetric and gynecologic items and
services, pursuant to the direct access described in subsection (a) of
this section by a participating qualified provider of such services, as
the authorization of the primary care provider.

(c) It shall be the duty of the administrative officer or other person
in charge of each insurer subject to the provisions of this article to
advise each female insured, in writing, of the provisions of this
section.