| (a) An issuer that covers reproductive health or reproductive
oncology services provided for women must reimburse physicians or providers
for those services at an amount not less than the annual average compensation
per hour or unit as would be paid in the service area for the same or similar
covered medical, surgical, hospital, pharmaceutical, nursing or other services,
as applicable, provided exclusively to men or to the general population.
(b) In determining appropriate reimbursement for reproductive
health or reproductive oncology services, the relative value units (RVUs)
published by the Centers for Medicare & Medicaid Services (CMS) shall
be considered, in addition to any other reimbursement methodologies submitted
by the physician or provider included as part of the complaint documentation
described in subparagraph (a)(6) of §21.3305 of this subchapter (relating
to Complaints), for comparing reimbursements of the same or comparable covered
services offered exclusively to men or to the general population.
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