2012 New York Consolidated Laws
PBH - Public Health
Article 44 - (4400 - 4414) HEALTH MAINTENANCE ORGANIZATIONS
4406-B - Primary and preventive obstetric and gynecologic care.

 
    §  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.