Page:United States Statutes at Large Volume 124.djvu/916

 124 STAT. 890 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(C) STABILIZE.—The term ‘to stabilize’, with respect to an emergency medical condition (as defined in subpara- graph (A)), has the meaning give in section 1867(e)(3) of the Social Security Act (42 U.S.C. 1395dd(e)(3)). ‘‘(c) ACCESS TO PEDIATRIC CARE.— ‘‘(1) PEDIATRIC CARE.—In the case of a person who has a child who is a participant, beneficiary, or enrollee under a group health plan, or health insurance coverage offered by a health insurance issuer in the group or individual market, if the plan or issuer requires or provides for the designation of a participating primary care provider for the child, the plan or issuer shall permit such person to designate a physician (allopathic or osteopathic) who specializes in pediatrics as the child’s primary care provider if such provider participates in the network of the plan or issuer. ‘‘(2) CONSTRUCTION.—Nothing in paragraph (1) shall be construed to waive any exclusions of coverage under the terms and conditions of the plan or health insurance coverage with respect to coverage of pediatric care. ‘‘(d) PATIENT ACCESS TO OBSTETRICAL AND GYNECOLOGICAL CARE.— ‘‘(1) GENERAL RIGHTS.— ‘‘(A) DIRECT ACCESS.—A group health plan, or health insurance issuer offering group or individual health insur- ance coverage, described in paragraph (2) may not require authorization or referral by the plan, issuer, or any person (including a primary care provider described in paragraph (2)(B)) in the case of a female participant, beneficiary, or enrollee who seeks coverage for obstetrical or gyneco- logical care provided by a participating health care profes- sional who specializes in obstetrics or gynecology. Such professional shall agree to otherwise adhere to such plan’s or issuer’s policies and procedures, including procedures regarding referrals and obtaining prior authorization and providing services pursuant to a treatment plan (if any) approved by the plan or issuer. ‘‘(B) OBSTETRICAL AND GYNECOLOGICAL CARE.—A group health plan or health insurance issuer described in para- graph (2) shall treat the provision of obstetrical and gyneco- logical care, and the ordering of related obstetrical and gynecological items and services, pursuant to the direct access described under subparagraph (A), by a participating health care professional who specializes in obstetrics or gynecology as the authorization of the primary care pro- vider. ‘‘(2) APPLICATION OF PARAGRAPH.—A group health plan, or health insurance issuer offering group or individual health insurance coverage, described in this paragraph is a group health plan or coverage that— ‘‘(A) provides coverage for obstetric or gynecologic care; and ‘‘(B) requires the designation by a participant, bene- ficiary, or enrollee of a participating primary care provider. ‘‘(3) CONSTRUCTION.—Nothing in paragraph (1) shall be construed to— ‘‘(A) waive any exclusions of coverage under the terms and conditions of the plan or health insurance coverage