Women's Access to Health Care; Health Insurance; Provision Disclosing Insured's Right to Direct Access to Obstetricians and Gynecologists Required

  1. Law
  2. Georgia Code
  3. Insurance
  4. Insurance Generally
  5. General Provisions
  6. Women's Access to Health Care; Health Insurance; Provision Disclosing Insured's Right to Direct Access to Obstetricians and Gynecologists Required

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  1. The General Assembly finds and declares that the specialty of obstetrics and gynecology is devoted to health care of women throughout their lifetimes.
    1. As used in this Code section, the term "health benefit policy" means any individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, or renewed in this state by a health care corporation, health maintenance organization, accident and sickness insurer, fraternal benefit society, or similar entity.
    2. Any accident and sickness policies, plans, or contracts which contain no provisions which require referrals from another physician for coverage of the services of an obstetrician or gynecologist shall not be required to give the notice required in subsection (d) of this Code section.
  3. No health benefit policy which is issued, delivered, issued for delivery, or renewed in this state shall require as a condition to the coverage of services of an obstetrician or gynecologist who is within the health benefit policy network of health care providers that an enrollee, subscriber, or insured first obtain a referral from another physician; provided, however, that the services covered by this subsection shall be limited to those services defined by the published recommendations of the Accreditation Council for Graduate Medical Education for training as an obstetrician or gynecologist, including, but not limited to, diagnosis, treatment, and referral.
  4. Each health benefit policy which is issued, delivered, issued for delivery, or renewed in this state shall disclose to enrollees, subscribers, or insureds, in clear, accurate language, such person's right to direct access to obstetricians and gynecologists as provided in this Code section.Such information shall be disclosed to each such person at the time of enrollment or otherwise first becoming an enrollee, subscriber, or insured, and at least annually thereafter.

(Code 1981, §33-24-59, enacted by Ga. L. 1996, p. 703, § 2; Ga. L. 1998, p. 1064, § 6; Ga. L. 2017, p. 164, § 30/HB 127; Ga. L. 2019, p. 386, § 61/SB 133.)

The 2019 amendment, effective July 1, 2019, deleted "on or after July 1, 1996," following "in this state" in subsections (c) and (d); and, in subsection (c), in the proviso, substituted "Council for Graduate" for "Council For Graduate", and inserted a comma following "including" and following "but not limited to" near the end.

Code Commission notes.

- Pursuant to Code Section 28-9-5, in 1996, this Code section, originally designated as Code Section 33-24-58, was redesignated as Code Section 33-24-59.

Editor's notes.

- Ga. L. 1996, p. 703, § 1, not codified by the General Assembly, provides: "This Act shall be known and may be cited as the 'Women's Access to Health Care Act.'"

Law reviews.

- For review of 1998 legislation relating to insurance, see 15 Ga. St. U.L. Rev. 153 (1998).


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