Utah § 31A-22-624 Primary care physician, physician assistant, or physical therapist.

Utah Statutes

§ 31A-22-624 — Primary care physician, physician assistant, or physical therapist.

Utah·Title 31A Insurance Code·Ch. 31A-22 Contracts in Specific Lines·Part 31A-22-6 Accident and Health Insurance

(1)An accident and health insurance policy that requires an insured to select a primary care provider or physician to receive optimum coverage shall permit an insured to select a participating provider who is:

(1)(a) (1)(a)(i) an obstetrician;

(1)(a)(ii) a gynecologist;

(1)(a)(iii) a pediatrician; or

(1)(a)(iv) a physician assistant who works with a physician:

(1)(a)(iv)(A) providing primary care; or

(1)(a)(iv)(B) described in Subsection (1)(a)(i), (ii), or (iii); and

(1)(b) qualified and willing to provide primary care services, as defined by the health care plan, as the insured's provider from whom primary care services are received.

(2)Subject to Subsection (5), an accident and health insurance policy that requires an insured to select a primary care provider or physician to receive o

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(1) An accident and health insurance policy that requires an insured to select a primary care provider or physician to receive optimum coverage shall permit an insured to select a participating provider who is:
(1)(a) (1)(a)(i) an obstetrician;
(1)(a)(ii) a gynecologist;
(1)(a)(iii) a pediatrician; or
(1)(a)(iv) a physician assistant who works with a physician:
(1)(a)(iv)(A) providing primary care; or
(1)(a)(iv)(B) described in Subsection (1)(a)(i), (ii), or (iii); and
(1)(b) qualified and willing to provide primary care services, as defined by the health care plan, as the insured's provider from whom primary care services are received.
(2) Subject to Subsection (5), an accident and health insurance policy that requires an insured to select a primary care provider or physician to receive optimum coverage may permit an insured to select a participating provider who is a physical therapist to provide physical therapy services.
(3) An accident and health insurance policy shall clearly state in literature explaining the policy the options available to insureds under Subsections (1) and (2).
(4) An accident and health insurance policy may not impose a higher premium, higher copayment requirement, or any other additional expense on an insured because the insured selected a primary care physician in accordance with this section.
(5) Notwithstanding Subsection (2), nothing in this section permits a physical therapist to practice physical therapy outside of the physical therapist's scope of practice under Title 58, Chapter 24b, Physical Therapy Practice Act.

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