Title 33, Chapter 24, Section 59
( 33-24-59)
(a) The General Assembly finds and declares that the specialty of
obstetrics and gynecology is devoted to health care of women
throughout their lifetimes. (b)(1) As used in this Code section, the term "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. (2) Any accident and sickness policies, plans, or contracts which
contain no provisions which require referrals from another
physician for coverage of the services of an obstetrician or
gynecologist shall not be required to give the notice required in
subsection (d) of this Code section. (c) No health benefit policy which is issued, delivered, issued for
delivery, or renewed in this state on or after July 1, 1996, shall
require as a condition to the coverage of services of an
obstetrician or gynecologist who is within the health benefit policy
network of health care providers that an enrollee, subscriber, or
insured first obtain a referral from another physician; provided,
however, that the services covered by this subsection shall be
limited to those services defined by the published recommendations
of the Accreditation Council For Graduate Medical Education for
training as an obstetrician or gynecologist, including but not
limited to diagnosis, treatment, and referral. (d) Each health benefit policy which is issued, delivered, issued
for delivery, or renewed in this state on or after July 1, 1996,
shall disclose to enrollees, subscribers, or insureds, in clear,
accurate language, such person's right to direct access to
obstetricians and gynecologists as provided in this Code section.
Such information shall be disclosed to each such person at the time
of enrollment or otherwise first becoming an enrollee, subscriber,
or insured, and at least annually thereafter. |