B.__If a female enrollee has not designated a physician who specializes in obstetrics and gynecology as her primary care physician, the carrier may not require authorization or referral by the enrollee's primary care physician for coverage of routine gynecological care, including annual examinations, and pregnancy-related services provided by a participating health care professional who specializes in obstetrics and gynecology to the extent such care is otherwise covered.__The carrier shall treat the ordering of other gynecological care by such a participating provider as the authorization of the primary care physician with respect to such care under the plan.

C.__This subsection may not be construed as waiving any requirements of coverage relating to medical necessity or appropriateness with respect to coverage of gynecological care ordered.

3.__Specialists as primary care physicians.__A carrier shall have a procedure to allow an enrollee who has an ongoing special condition to receive a referral to a specialist who is responsible for and capable of providing and coordinating the enrollee's primary and specialty care.__If the enrollee's care would most appropriately be coordinated by such a specialist, the carrier shall allow the specialist to serve as the enrollee's primary care physician.__A specialist treating an enrollee in accordance with this subsection must be permitted to treat the enrollee without a referral from the enrollee's primary care physician and may authorize any referrals, procedures, tests and other medical services the enrollee's primary care physician would otherwise be permitted to provide or authorize, subject to the terms of a treatment plan.

4.__Referrals to specialists.__If an enrollee has a condition or disease of sufficient seriousness and complexity to require treatment by a specialist and benefits for such treatment are provided under the plan, the carrier shall make or provide for a referral to a specialist who is available and accessible to provide the treatment for that condition or disease in accordance with the following.

A.__A carrier may require that the care provided to an enrollee as a result of a referral under this subsection be pursuant to a treatment plan developed by the specialist and approved by the carrier in consultation with the enrollee and the enrollee's primary care physician in accordance with applicable quality assurance and utilization review standards of the carrier.