33-24-56
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33-24-56.
(a)
It is the intent of the General Assembly to encourage health care cost
containment while preserving the quality of care offered to citizens of this
state. The General Assembly finds that there is an increasing number of health
insurance benefit providers which require a referral from a primary care
physician to a dermatologist as a condition of the payment of benefits to an
insured patient. The General Assembly finds that such a requirement as it
relates to dermatological services may block unfairly a patient´s choice of
direct access to providers of health care services and may not be in the public
interest.
(b)
As used in this Code section, the term:
(1)
'Dermatological services' means services ordinarily and customarily rendered by
a physician specializing in the practice of dermatology.
(2)
'Health benefit policy' means any individual or group plan, policy, or contract
for health care services issued, delivered, issued for delivery, or renewed in
this state by a health care corporation, health maintenance organization,
accident and sickness insurer, fraternal benefit society, nonprofit hospital
service corporation, nonprofit medical service corporation, or similar entity.
(c)
No health benefit policy which is issued, delivered, issued for delivery, or
renewed in this state on or after July 1, 1995, shall require as a condition to
the coverage of dermatological services that an enrollee, subscriber, or insured
first obtain a referral from a primary care physician, as such term is defined
by the group plan, policy, or contract for health care services.