2001 Minnesota Statutes

     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 
 copayments, 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