Ch. 580

1996 LAWS OF MARYLAND

the patient first visiting a primary care provider, and does not account for the women who
must see their OB/GYN more than once in a 12-month period; and

WHEREAS, Allowing women to receive all gynecological care from certain
OB/GYN doctors without first requiring them to visit a primary care physician would
improve their access to OB/GYN doctors; now, therefore,

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:

Article 48A - Insurance Code

490Z.

(a) Any insurer or nonprofit health service plan that provides hospital, medical, or
surgical benefits for issuance or delivery in the State to any group or individual on an
expense-incurred basis, including a health maintenance organization, shall:

(1)     Classify an obstetrician/gynecologist as a primary care physician; or

(2)     [Permit] IF THE OBSTETRICIAN/GYNECOLOGIST CHOOSES NOT TO
BE A PRIMARY CARE PHYSICIAN, PERMIT a woman to receive [ an annual visit to an
in-network obstetrician/gynecologist for routine] gynecological care FROM AN
IN-NETWORK OBSTETRICIAN/GYNECOLOGIST without requiring the woman to first visit
a primary care provider, PROVIDED THAT:

(I)      THE CARE IS MEDICALLY NECESSARY, INCLUDING, BUT NOT
LIMITED TO, CARE THAT IS ROUTINE; AND

(II)     FOLLOWING EACH VISIT FOR GYNECOLOGICAL CARE, THE
OBSTETRICIAN/GYNECOLOGIST COMMUNICATES WITH THE WOMAN'S PRIMARY
CARE PHYSICIAN CONCERNING ANY DIAGNOSIS OR TREATMENT RENDERED; AND

(III) THE OBSTETRICIAN/GYNECOLOGIST OBTAINS APPROVAL
FROM CONFERS WITH THE PRIMARY CARE PHYSICIAN BEFORE PERFORMING ANY
DIAGNOSTIC OR NONEMERGENCY PROCEDURE THAT IS NOT ROUTINE
GYNECOLOGICAL CARE RENDERED DURING AN ANNUAL VISIT.

Article - Health - General

19-706.

(k) (1) A health maintenance organization shall:

(i) Classify an obstetrician/gynecologist as a primary care physician; or

(ii) [Permit] IF THE OBSTETRICIAN/GYNECOLOGIST CHOOSES NOT
TO BE A PRIMARY CARE PHYSICIAN, PERMIT a woman to receive [an annual visit to an
in-network obstetrician/gynecologist for routine] gynecological care FROM AN
IN-NETWORK OBSTETRICIAN/GYNECOLOGIST without requiring the woman to first visit
a primary care provider, PROVIDED THAT:

1. THE CARE IS MEDICALLY NECESSARY, INCLUDING, BUT
NOT LIMITED TO, CARE THAT IS ROUTINE; AND

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