Internal Revenue Code · 26 U.S.C.
§ 9822. Other patient protections
Official text, no changes From the Office of the Law Revision Counsel, release point 119-121 (current through Public Law 119-121 (October 9, 2026)). Compare it with the official text at uscode.house.gov (external site).
Cite as 26 U.S.C. § 9822
At a glance
Read from the text, the source credit and the official notes. Not part of the law.
- Status
- In force
- Added
- December 27, 2020 by Pub. L. 116–260
- Length
- 3 subsections · 444 words · about 2 min to read
- Regulations
- 1 issued under this section
If a group health plan requires or provides for designation by a participant or beneficiary of a participating primary care provider, then the plan shall permit each participant and beneficiary to designate any participating primary care provider who is available to accept such individual.
In the case of a person who has a child who is a participant or beneficiary under a group health plan if the plan requires or provides for the designation of a participating primary care provider for the child, the plan shall permit such person to designate a physician (allopathic or osteopathic) who specializes in pediatrics as the child’s primary care provider if such provider participates in the network of the plan.
Nothing in paragraph (1) shall be construed to waive any exclusions of coverage under the terms and conditions of the plan with respect to coverage of pediatric care.
A group health plan described in paragraph (2) may not require authorization or referral by the plan, issuer, or any person (including a primary care provider described in paragraph (2)(B)) in the case of a female participant or beneficiary who seeks coverage for obstetrical or gynecological care provided by a participating health care professional who specializes in obstetrics or gynecology. Such professional shall agree to otherwise adhere to such plan’s policies and procedures, including procedures regarding referrals and obtaining prior authorization and providing services pursuant to a treatment plan (if any) approved by the plan.
A group health plan described in paragraph (2) shall treat the provision of obstetrical and gynecological care, and the ordering of related obstetrical and gynecological items and services, pursuant to the direct access described under subparagraph (A), by a participating health care professional who specializes in obstetrics or gynecology as the authorization of the primary care provider.
(Added Pub. L. 116–260, div. BB, title I, § 102(c)(2), Dec. 27, 2020, 134 Stat. 2795.)
Regulations under this section
Treasury regulations (26 CFR) issued under § 9822
Amendment history
From the source credit and the official notes, newest first.
- Added by Pub. L. 116–260
Where it sits in the Code
- Subtitle K Group Health Plan Requirements
- Chapter 100 GROUP HEALTH PLAN REQUIREMENTS
- Subchapter B Other Requirements
Nearby sections
- § 9817 Ending surprise air ambulance bills
- § 9818 Continuity of care
- § 9819 Maintenance of price comparison tool
- § 9820 Protecting patients and improving the accuracy of provider directory information
- § 9822 Other patient protections
- § 9823 Air ambulance report requirements
- § 9824 Increasing transparency by removing gag clauses on price and quality information
- § 9825 Reporting on pharmacy benefits and drug costs
- § 9826 Oversight of entities that provide pharmacy benefit management services
Official notes
Show the Law Revision Counsel's notes (amendments, effective dates)
Statutory Notes and Related Subsidiaries
Effective Date
Section applicable with respect to plan years beginning on or after Jan. 1, 2022, see section 102(e) of div. BB of Pub. L. 116–260, set out as an Effective Date of 2020 Amendment note under section 8902 of Title 5, Government Organization and Employees.