§ 38-71-215 — Dermatology referrals.

(A) If a primary care physician makes a referral to a dermatologist, the enrollee in a managed care plan may see the in-network dermatologist to whom the enrollee is referred, without further referral, for a minimum of six months or four visits, whichever first occurs, for diagnosis, medical treatment, or surgical procedures for the referral problem or related complications. (B) Written communication from the dermatologist should be sent to the primary care physician after each visit. (C) An enrollee with a documented past history of malignant melanoma may be referred by his or her primary care physician to an in-network dermatologist for an annual evaluation and, as necessary, biopsy or surgery, or both. (D) All services provided pursuant to this section are subject to contractual provisions regarding medical necessity and benefit coverage. (E) Nothing in this section may be construed to extend benefits to an enrollee past the contract period.

Legislative History

HISTORY: 1998 Act No. 353, SECTION 1.