Bill > H1168

This bill eliminates the requirement for patients to obtain a primary care provider (PCP) referral before accessing certain specialty gynecological services. Specifically, the legislation removes the need for prior authorization from a primary care provider when an insured individual seeks care from an obstetrician, gynecologist, certified nurse-midwife, or family practitioner within their health insurance network. The services that can now be accessed without a referral include annual preventive gynecologic exams, follow-up services deemed medically necessary from those exams, preventative and menstrual health care (covering conditions like abnormal uterine bleeding and pelvic pain), maternity care, and medically necessary evaluations for acute or emergency gynecological conditions. By removing this referral barrier, the bill aims to improve women's direct access to specialized reproductive and gynecological healthcare, potentially reducing delays in receiving important medical services and making healthcare more convenient for patients.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/194/H1168