Insurance Law 4306-B — Legislation

Legislation Search OpenLegislation Statutes Search Term Search icon Search previous SECTION 4306-A Health insurance coverage for full-time students on medical leaves of absence up ARTICLE 43 Non-profit Medical and Dental Indemnity, or Health and Hospital Service Corporations next SECTION 4306-C Grievance procedure and access to specialty care Viewing most recent revision (from 2014-09-22) View historical revision as of: -- Choose a Date -- 2014-09-22 Share Facebook Email SECTION 4306-B Primary and preventive obstetric and gynecologic care Insurance (ISC) CHAPTER 28, ARTICLE 43 § 4306-b. Primary and preventive obstetric and gynecologic care. (a) No corporation subject to the provisions of this article shall by contract, written policy or procedure limit a female subscriber'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 subscriber's primary care practitioner in accordance with the requirements of the corporation; and (2) such qualified provider agrees to adhere to the corporation'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 corporation. (b) A corporation 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 corporation subject to the provisions of this article to advise each female subscriber, in writing, of the provisions of this section.