First Regular Session
Sixty-second General Assembly
LLS NO. 99-0339.01 Julie Hoerner SENATE BILL 99-022
STATE OF COLORADO
BY SENATOR Wham;
also REPRESENTATIVE Tool.
REREVISED HEALTH, ENVIRONMENT, WELFARE & INSTITUTIONS
A BILL FOR AN ACT
101 CONCERNING COVERAGE UNDER A HEALTH BENEFIT PLAN OF HEALTH CARE
102 SERVICES RELATED TO A WOMAN'S REPRODUCTIVE SYSTEM
103 PROVIDED BY PARTICIPATING PHYSICIANS WHO ROUTINELY
104 PRACTICE WOMEN'S REPRODUCTIVE SYSTEM HEALTH CARE.
Bill Summary
(Note: This summary applies to this bill as introduce d and does
not necessarily reflect any amendments that may be subsequently
adopted.)
Allows a woman direct access to an obstetrician and gynecologist
regardless of whether the health insurance plan is a subdivided plan.
1 Be it enacted by the General Assembly of the State of Colorado:
2 {SECTION 1. The introductory portion to 10-16-107 (5),
3 10-16-107 (5) (a), and the introductory portion to 10-16-107 (5) (b) (I),
4 Colorado Revised Statutes,}[ are amended to read:
5 ]{
6 10-16-107. Rate regulation - approval of policy forms - benefit
7 certificates - evidences of coverage - loss ratio guarantees - disclosures
8 on treatment of intractable pain. (5) A WOMAN COVERED UNDER A
9 PLAN, NOTWITHSTANDING ANY SUBDIVISIONS OF THE PLAN'S NETWORK,
10 THAT IS SUBJECT TO THE PROVISIONS OF THIS SUBSECTION (5) SHALL BE
[ ] denotes HOUSE amendment. { } denotes SENATE amendment.
Capital letters indicate new material to be added to existing statute.
Dashes through the words indicate material to be deleted from existing statute.
Page 2
1 ENTITLED TO SELECT ANY }[OBSTETRICIAN OR]{ GYNECOLOGIST [ }THAT IS
2 AFFILIATED WITH THE PLAN. THE OBSTETRICIAN, GYNECOLOGIST, OR AN
3 ADVANCED PRACTICE NURSE WHO IS A CERTIFIED NURSE MIDWIFE
4 PURSUANT TO SECTION 12-38-111.5, C.R.S., SELECTED BY A WOMAN
5 COVERED UNDER THE PLAN SHALL TRANSMIT TO THE PRIMARY CARE
6 PROVIDER OF THE COVERED WOMAN A WRITTEN REPORT OF THE
7 TREATMENT AFTER EACH VISIT. Effective{ ]January 31, 1997, a managed
8 care plan that provides coverage for reproductive health or gynecological
9 care shall not be issued or renewed unless such }[plan either:]{
10 (a) Provides a woman covered by the plan direct access to an
11 obstetrician, gynecologist, [ ] or an advanced practice nurse who is a
12 certified nurse midwife pursuant to section 12-38-111.5, C.R.S.,
13 participating and available under the plan for her reproductive health care
14 or gynecological care; or
15 (b) (I) Subject to rules promulgated by the commissioner, has
16 procedures in place that ensure that, if a woman covered by the plan
17 requests a timely referral to an obstetrician, gynecologist, [ ] [ ] or an
18 advanced practice nurse who is a certified nurse midwife pursuant to
19 section 12-38-111.5, C.R.S., participating and available under the plan for
20 her reproductive health and gynecological care, the request for referral
21 shall not be unreasonably withheld. Such rules shall include, but need
22 not be limited to, the following issues:
23 }[ ]{
24 [} {]
25 SECTION 2. Effective date - applicability. This act shall take
26 effect July 1, 1999, and shall apply to all claims related to reproductive
Page 3
1 health filed by a woman covered under a plan on or after said date.
2 SECTION 3. Safety clause. The general assembly hereby finds,
3 determines, and declares that this act is necessary for the immediate
4 preservation of the public peace, health, and safety.}