(a) In general, subject to subsection (b) of this section, a health benefits plan shall permit a member to receive medically necessary or appropriate specialty care for more than one visit without having to obtain the insurer’s approval for subsequent visits authorized by a primary care provider.
(b) Subsection (a) of this section shall not apply to specialty care if the insurer informs the member, orally and in writing, of any limitation on the choice of participating providers with respect to such care.
(Apr. 27, 1999, D.C. Law 12-274, § 202, 46 DCR 1294.)
1981 Ed., § 32-572.2.
Structure District of Columbia Code
Title 44 - Charitable and Curative Institutions
Chapter 3 - Grievance Procedures for Health Benefits Plans
Subchapter II - Access to Specialists as Primary Care Providers
§ 44–302.01. Specialists as primary care providers
§ 44–302.02. Standing referrals to specialists
§ 44–302.03. Direct access to qualified specialists for females’ health services