354.546. Second medical opinion to be allowed by health maintenance organizations, procedure, costs. - Missouri Statutes

Second medical opinion to be allowed by health maintenanceorganizations, procedure, costs.

354.546. 1. A health maintenance organization shall allow enrolleesto seek a second medical opinion or consultation from the healthmaintenance organization's choice of other primary care physicians andspecialty physicians at no additional cost to the enrollee beyond what theenrollee would otherwise pay for an initial medical opinion orconsultation.

2. If an enrollee chooses to seek a second medical opinion, and ifthe health maintenance organization does not employ or contract withanother physician with the expertise necessary to provide a second medicalopinion, then the health maintenance organization shall arrange for areferral to a physician with the necessary expertise to provide a secondopinion or consultation and ensure that the enrollee obtains the coveredbenefit at no greater cost to the enrollee than if the benefit wereobtained from participating physicians.

(L. 1998 S.B. 754)

CROSS REFERENCE:

Second medical opinions covered, when, RSMo 354.207