SF 398

as introduced - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to insurance; requiring health plan companies 
  1.3             to provide direct access to obstetric and gynecologic 
  1.4             services; proposing coding for new law in Minnesota 
  1.5             Statutes, chapter 62Q. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  [62Q.52] [DIRECT ACCESS TO OBSTETRIC AND 
  1.8   GYNECOLOGIC SERVICES.] 
  1.9      (a) Health plan companies shall allow female enrollees 
  1.10  direct access to obstetricians and gynecologists for the 
  1.11  following services: 
  1.12     (1) annual preventive health examinations, which shall 
  1.13  include a gynecologic examination, and any subsequent obstetric 
  1.14  or gynecologic visits determined to be medically necessary by 
  1.15  the examining obstetrician or gynecologist, based upon the 
  1.16  findings of the examination; 
  1.17     (2) maternity care; and 
  1.18     (3) evaluation and necessary treatment for acute 
  1.19  gynecologic conditions or emergencies. 
  1.20     (b) For purposes of this section, "direct access" means 
  1.21  that a female enrollee may obtain the obstetric and gynecologic 
  1.22  services specified in paragraph (a) from obstetricians and 
  1.23  gynecologists in the enrollee's network without a referral from, 
  1.24  or prior approval through, another physician, the health plan 
  1.25  company, or its representatives. 
  2.1      (c) Health plan companies shall not require higher 
  2.2   copayments, coinsurance, deductibles, or other enrollee 
  2.3   cost-sharing for direct access. 
  2.4      (d) This section applies only to services described in 
  2.5   paragraph (a) that are covered by the enrollee's coverage, but 
  2.6   coverage of a preventive health examination for female enrollees 
  2.7   must not exclude coverage of a gynecologic examination. 
  2.8      Sec. 2.  [EFFECTIVE DATE.] 
  2.9      Section 1 is effective January 1, 1998, and applies to 
  2.10  coverage issued or renewed on or after that date.