Maine Revised Statutes
Subchapter 1: HEALTH PLAN REQUIREMENTS
24-A §4306-A. Patient access to obstetrical and gynecological care

§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

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 Definitions (REPEALED)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 §4301-A. Definitions

24-A §4302. Reporting requirements

24-A §4303. Plan 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 §4303-E. Dispute resolution process for surprise bills and bills for out-of-network emergency services

24-A §4303-F. Reimbursement for ambulance services and participation of ambulance service providers in carrier networks

24-A §4304. Utilization review

24-A §4305. Quality of care

24-A §4306. Enrollee choice of primary care provider

24-A §4306-A. Patient access to obstetrical and gynecological care

24-A §4307. Construction

24-A §4308. Indemnification

24-A §4309. Adoption of rules

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 §4318. Prohibition against maximum aggregate benefit provisions (REALLOCATED FROM TITLE 24-A, SECTION 4317) (REPEALED)

24-A §4318-A. Comparable health care service incentive program (WHOLE SECTION TEXT EFFECTIVE UNTIL 1/1/24) (WHOLE SECTION TEXT REPEALED 1/1/24)

24-A §4318-B. Access to lower-priced services (WHOLE SECTION TEXT EFFECTIVE UNTIL 1/1/24) (WHOLE SECTION TEXT REPEALED 1/1/24)

24-A §4319. Rebates

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-F. Oversight of plans offered on the American Health Benefit Exchange and the SHOP Exchange

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-Q. Coverage for services provided by a certified registered nurse anesthetist (REALLOCATED FROM TITLE 24-A, SECTION 4320-P)

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-T. Implementation of federal mental health parity laws (WHOLE SECTION TEXT EFFECTIVE UNTIL 4/30/28) (WHOLE SECTION TEXT REPEALED 4/30/28) (REALLOCATED FROM TITLE 24-A, SECTION 4320-R)

24-A §4320-U. Coverage for fertility services (REALLOCATED FROM TITLE 24-A, SECTION 4320-S)