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This entry was published on 2014-09-22
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Primary and preventive obstetric and gynecologic care
Public Health (PBH) CHAPTER 45, ARTICLE 44
§ 4406-b. Primary and preventive obstetric and gynecologic care. 1.
The health maintenance organization shall not limit a female enrollee'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: (a) such
qualified provider discusses such services and treatment plan with the
enrollee's primary care practitioner in accordance with the requirements
of the health maintenance organization; and (b) such qualified provider
agrees to adhere to the health maintenance organization'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
health maintenance organization.

2. A health maintenance organization 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 subdivision one of this section by a participating
qualified provider of such services, as the authorization of the primary
care provider.

3. It shall be the duty of the administrative officer or other person
in charge of each health maintenance organization to advise each female
enrollee, in writing, of the provisions of this section.