354.554. Standing referrals for certain members of community-based health maintenance organizations, when. - Missouri Statutes

Standing referrals for certain members of community-based healthmaintenance organizations, when.

354.554. Each community-based health maintenance organization shalloffer coverage that allows an enrollee who suffers from a life-threateningcondition or a degenerative, disabling condition requiring a regimen ofspecialized medical treatment lasting for six months or more to receive astanding referral for specialty care case management by a physician orspecialty care center with expertise in treating the condition. Under suchspecialty care case management, the provider shall coordinate primary andspecialty care for the enrollee under a treatment plan approved by thehealth maintenance organization in consultation with the enrollee's primarycare provider and the specialist physician or specialty care center.

(L. 1997 H.B. 335 § 2)