WVC 33 - 42 - 4
§33-42-4. Limitations on conditions of coverage.
No health benefits policy may require as a condition to the
coverage of basic primary and preventative obstetrical and
gynecological services that a woman first obtain a referral from a
primary care physician: Provided
, That for a health maintenance
organization authorized under article twenty-five-a of this
chapter, direct access, at least annually, to a women's health care
provider for purposes of a well woman examination shall satisfy the
foregoing requirement. No health benefits policy may require as a
condition to the coverage of prenatal or obstetrical care that a
woman first obtain a referral for those services by a primary care
physician. No health benefits policy providing coverage for
surgical services in a hospital inpatient or outpatient setting may
deny coverage for: (1) Reconstruction of the breast following
mastectomy; or (2) reconstructive or cosmetic surgery required as
a result of an injury caused by an act of family violence as
defined in section three, article two-a, chapter forty-eight of
this code, when the person inflicting the injury was convicted of
a felony, a lesser included misdemeanor offense, or a charge of
domestic battery for inflicting the injury.
Note: WV Code updated with legislation passed through the 2013 1st Special Session
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