Ohio Revised Code
Chapter 1753 | Physician-Health Plan Partnership Act; Risk-Based Capital for Insurers Model Act
Section 1753.13 | Obtaining Covered Obstetric and Gynecological Services Without Referral.

Effective: October 14, 1999
Latest Legislation: House Bill 4 - 123rd General Assembly
Every individual or group health insuring corporation policy, contract, or agreement that provides basic health care services but does not allow direct access to obstetricians or gynecologists shall permit a female enrollee to obtain covered obstetric and gynecological services from a participating obstetrician or gynecologist without obtaining a referral from the enrollee's primary care provider.
No individual or group health insuring corporation policy, contract, or agreement may limit the number of allowable visits to a participating obstetrician or gynecologist. A health insuring corporation may require a participating obstetrician or gynecologist to comply with the health insuring corporation's coverage protocols and procedures, including utilization review, for obstetric and gynecological services.
A health insuring corporation policy, contract, or agreement may not impose additional copayments for directly accessed obstetric and gynecological services, unless the policy, contract, or agreement imposes additional copayments for direct access to any participating provider other than a primary care provider.

Structure Ohio Revised Code

Ohio Revised Code

Title 17 | Corporations-Partnerships

Chapter 1753 | Physician-Health Plan Partnership Act; Risk-Based Capital for Insurers Model Act

Section 1753.01 | Physician-Health Plan Partnership Act Definitions.

Section 1753.06 | Notice of Status of the Provider's Application.

Section 1753.07 | Information Given to Provider.

Section 1753.09 | Terminating Participation of Provider.

Section 1753.10 | Categories of Providers.

Section 1753.13 | Obtaining Covered Obstetric and Gynecological Services Without Referral.

Section 1753.14 | Procedures for Standing Referrals to Specialists.

Section 1753.16 | Retroactively Denying Authorization.

Section 1753.21 | Prescription Drugs.

Section 1753.23 | Internal Technology Assessment Process.

Section 1753.28 | Emergency Services Coverage.

Section 1753.30 | Other Insurance Provisions.

Section 1753.31 | Risk-Based Capital for Insurers Model Act Definitions.

Section 1753.32 | Annual Report.

Section 1753.33 | Company Action Level Event.

Section 1753.34 | Regulatory Action Level Event.

Section 1753.35 | Authorized Control Level Event.

Section 1753.36 | Mandatory Control Level Event.

Section 1753.37 | Right to Confidential Hearing - Request for Hearing - Challenge to Determination or Action.

Section 1753.38 | Confidentiality.

Section 1753.39 | Foreign Health Insuring Corporation.

Section 1753.40 | Immunity.

Section 1753.41 | When Notices Are Effective.

Section 1753.42 | Requirements for Exemption of Domestic Corporation.

Section 1753.43 | Rules.