§4306-A. Patient access to obstetrical and gynecological care
Notwithstanding any other requirements of this Title, a carrier offering a health plan in this State subject to the requirements of the federal Affordable Care Act: [PL 2011, c. 364, §29 (NEW).]
1. Authorization or referral not required. May not require authorization or referral by the carrier or any other person, including a primary care provider, in the case of a female enrollee who seeks coverage for obstetrical or gynecological care provided by a participating health care professional as described in the federal Affordable Care Act who specializes in obstetrics or gynecology. The health care professional shall agree to otherwise adhere to the health plan's or carrier's policies and procedures, including procedures regarding referrals and obtaining prior authorization and providing services pursuant to a treatment plan, if any, approved by the carrier; and
[PL 2011, c. 364, §29 (NEW).]
2. Treated as primary care. Shall treat the provision of obstetrical and gynecological care by a participating health care professional as described in the federal Affordable Care Act who specializes in obstetrics or gynecology, pursuant to subsection 1, as authorized by the primary care provider and the authorization of related obstetrical and gynecological items and services by that professional as the authorization of the primary care provider.
[PL 2011, c. 364, §29 (NEW).]
SECTION HISTORY
PL 2011, c. 364, §29 (NEW).
Structure Maine Revised Statutes
TITLE 24-A: MAINE INSURANCE CODE
Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT
Subchapter 1: HEALTH PLAN REQUIREMENTS
24-A §4301. Definitions (REPEALED)
24-A §4302. Reporting requirements
24-A §4303-A. Provider profiling programs
24-A §4303-B. Disclosure related to provider networks
24-A §4303-C. Protection from surprise bills and bills for out-of-network emergency services
24-A §4303-D. Provider directories
24-A §4304. Utilization review
24-A §4306. Enrollee choice of primary care provider
24-A §4306-A. Patient access to obstetrical and gynecological care
24-A §4309-A. Compliance with the Affordable Care Act
24-A §4310. Access to clinical trials
24-A §4311. Access to prescription drugs
24-A §4312. Independent external review
24-A §4313. Carrier liability; cause of action
24-A §4314. Access to eye care providers
24-A §4314-A. Coverage for early refills of prescription eye drops
24-A §4315. Coverage of prosthetic devices
24-A §4316. Coverage for telehealth services
24-A §4317. Pharmacy providers
24-A §4317-A. Prescription drug coverage; out-of-pocket expenses for coinsurance
24-A §4317-B. Orally administered cancer therapy
24-A §4317-C. Coverage for prescription insulin drugs; limit on out-of-pocket costs
24-A §4317-D. Coverage of HIV prevention drugs
24-A §4317-E. Coverage for emergency supply of chronic maintenance drugs
24-A §4319-A. Guaranteed issue
24-A §4319-B. Medical loss ratio reporting for dental insurance plans
24-A §4320. No lifetime or annual limits on health plans
24-A §4320-A. Coverage of preventive and primary health services
24-A §4320-B. Extension of dependent coverage
24-A §4320-C. Emergency services
24-A §4320-D. Comprehensive health coverage
24-A §4320-E. Reinsurance, risk corridors and risk adjustment
24-A §4320-G. Applicability to health plans grandfathered under the Affordable Care Act
24-A §4320-H. Payment reform pilot projects (REALLOCATED FROM TITLE 24-A, SECTION 4320)
24-A §4320-I. Coverage for the cost of testing for bone marrow donation suitability
24-A §4320-J. Coverage for abuse-deterrent opioid analgesic drug products
24-A §4320-K. Coverage for services provided by a naturopathic doctor
24-A §4320-L. Nondiscrimination
24-A §4320-M. Coverage for abortion services
24-A §4320-N. Step therapy (REALLOCATED FROM TITLE 24-A, SECTION 4320-M)
24-A §4320-O. Coverage for services provided by a physician assistant
24-A §4320-P. Coverage for health care services for COVID-19
24-A §4320-R. Mandatory offer of coverage for certain adults with disabilities
24-A §4320-S. Coverage for dental services for cancer patients
24-A §4320-U. Coverage for fertility services (REALLOCATED FROM TITLE 24-A, SECTION 4320-S)