Sec. 38a-503b. Carriers to permit direct access to obstetrician-gynecologist.
Sec. 38a-503b. Carriers to permit direct access to obstetrician-gynecologist.
(a) As used in this section, "carrier" means each insurer, health care center, hospital and
medical service corporation or other entity delivering, issuing for delivery, renewing
or amending any individual health insurance policy in this state on or after October 1,
1995, providing coverage of the type specified in subdivisions (1), (2), (4), (6), (10),
(11) and (12) of section 38a-469.
(b) Each carrier shall permit a female enrollee direct access to a participating in-network obstetrician-gynecologist for any gynecological examination or care related
to pregnancy and shall allow direct access to a participating in-network obstetrician-gynecologist for primary and preventive obstetric and gynecologic services required as
a result of any gynecological examination or as a result of a gynecological condition.
Such obstetric and gynecologic services include, but are not limited to, pap smear tests.
The plan may require the participating in-network obstetrician-gynecologist to discuss
such services and any treatment plan with the female enrollee's primary care provider.
Nothing in this section shall preclude access to an in-network nurse-midwife as licensed
pursuant to sections 20-86c and 20-86g and in-network advanced practice nurses, as
licensed pursuant to sections 20-93 and 20-94a for obstetrical and gynecological services
within their scope of practice.
(c) Each carrier may allow a female enrollee to designate either a participating, in-network obstetrician-gynecologist or any other in-network physician designated by the
carrier as a primary care provider, or both, and may offer the same choice to all female
enrollees.
(P.A. 95-199, S. 1; P.A. 96-227, S. 14; P.A. 01-171, S. 18.)
History: P.A. 96-227 amended Subsec. (a) to include Subdiv. (12) in its citation to Sec. 38a-469; P.A. 01-171 amended
Subsec. (b) to provide that "such obstetric and gynecologic services include, but are not limited to, pap smear tests".
See Sec. 38a-530b for similar provisions re group policies.