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Ch. 402
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PARRIS N. GLENDENING, Governor
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(2) If a health maintenance organization classifies an
obstetrician/gynecologist as a primary care physician as provided under paragraph (1)
of this subsection, and a woman does not choose an obstetrician/gynecologist as her
primary care provider, the health maintenance organization shall permit the woman
to receive an annual visit to an in-network obstetrician/gynecologist for routine
gynecological care without requiring the woman to first visit her primary care
provider, whether or not the primary care provider is qualified to and regularly
provides routine gynecological care.
(3) (I) A HEALTH MAINTENANCE ORGANIZATION MAY NOT LIMIT A
WOMAN'S DIRECT ACCESS TO PRIMARY AND PREVENTIVE OBSTETRIC AND
GYNECOLOGICAL SERVICES FROM A CERTIFIED NURSE MIDWIFE OR AMY OTHER
PROVIDER AUTHORIZED UNDER THE HEALTH OCCUPATIONS ARTICLE TO PROVIDE
OBSTETRIC AND GYNECOLOGICAL SERVICES.
(II) A HEALTH MAINTENANCE ORGANIZATION SHALL ALLOW A
WOMAN TO CHOOSE A CERTIFIED NURSE MIDWIFE PARTICIPATING IN THE HEALTH
MAINTENANCE ORGANIZATION IF THE CERTIFIED NURSE MIDWIFE DISCUSSES THE
SERVICES AND TREATMENT PLAN WITH THE WOMAN'S PRIMARY CARE PROVIDER
AND INFORMS THE WOMAN'S PRIMARY CARE PROVIDER OF ALL HEALTH SERVICES
PROVIDED.
(III) A HEALTH MAINTENANCE ORGANIZATION SHALL OFFER THE
WOMAN THE CHOICE OF AN OBSTETRIC AND GYNECOLOGICAL PROVIDER WITHIN
THE HEALTH MAINTENANCE ORGANIZATION AND MAY NOT REQUIRE THE WOMAN
TO RECEIVE OBSTETRIC AND GYNECOLOGICAL SERVICES FROM A SPECIFIC
CATEGORY OF PROVIDER
(3) (I) A HEALTH MAINTENANCE ORGANIZATION SHALL ALLOW A
WOMAN TO RECEIVE MEDICALLY NECESSARY, ROUTINE OBSTETRIC AND
GYNECOLOGICAL CARE FROM AN IN-NETWORK, CERTIFIED NURSE MIDWIFE OR ANY
OTHER IN-NETWORK PROVIDER AUTHORIZED UNDER THE HEALTH OCCUPATIONS
ARTICLE TO PROVIDE OBSTETRIC AND GYNECOLOGICAL SERVICES WITHOUT FIRST
REQUIRING THE WOMAN TO VISIT A PRIMARY CARE PROVIDER
(II) A CERTIFIED NURSE MIDWIFE OR OTHER NONPHYSICIAN
PROVIDER AUTHORIZED UNDER THE HEALTH OCCUPATIONS ARTICLE TO PROVIDE
OBSTETRIC AND GYNECOLOGICAL SERVICES SHALL CONSULT WITH AN
OBSTETRICIAN/GYNECOLOGIST WITH WHOM THE CERTIFIED NURSE MIDWIFE OR
OTHER PROVIDER HAS A COLLABORATIVE AGREEMENT, IN ACCORDANCE WITH THE
COLLABORATIVE AGREEMENT, REGARDING ANY CARE RENDERED IN ACCORDANCE
WITH UNDER THIS PARAGRAPH.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply
applies to all policies, contracts, and health benefit plans issued, delivered, or
renewed in the State on or after October 1, 2000. Any policy, contract, or health
benefit plan in effect before October 1, 2000 shall comply with the provisions of this
Act no later than October 1, 2001.
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- 2199 -
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