2005 Minnesota Statutes - 62Q.52 — Direct access to obstetric and gynecologic services.

     62Q.52 Direct access to obstetric and gynecologic 
  services. 


    (a) Health plan companies shall allow female enrollees 
 direct access to obstetricians and gynecologists for the 
 following services: 


    (1) annual preventive health examinations, which shall 
 include a gynecologic examination, and any subsequent obstetric 
 or gynecologic visits determined to be medically necessary by 
 the examining obstetrician or gynecologist, based upon the 
 findings of the examination; 


    (2) maternity care; and 


    (3) evaluation and necessary treatment for acute 
 gynecologic conditions or emergencies. 


    (b) For purposes of this section, "direct access" means 
 that a female enrollee may obtain the obstetric and gynecologic 
 services specified in paragraph (a) from obstetricians and 
 gynecologists in the enrollee's network without a referral from, 
 or prior approval through, another physician, the health plan 
 company, or its representatives. 


    (c) Health plan companies shall not require higher 
 co-payments, coinsurance, deductibles, or other enrollee 
 cost-sharing for direct access. 


    (d) This section applies only to services described in 
 paragraph (a) that are covered by the enrollee's coverage, but 
 coverage of a preventive health examination for female enrollees 
 must not exclude coverage of a gynecologic examination. 


    HIST: 1997 c 26 s 1