- (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.
HISTORY: 1998 Act No. 353, Section 1.