Utah Code § 31A-22-624 — Utah Code / Title 31A / Chapter 31A-22 / § 31A-22-624
§ 31A-22-624. Primary care physician, physician assistant, or physical therapist.
Status: in_force

1/1/2027 (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: (a) (i) an obstetrician; (ii) a gynecologist; (iii) a pediatrician; or (iv) a physician assistant who has trained in a primary care physician's office and completed the physician assistant's collaboration requirement described in Section 58-70a-307; and (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 (6), 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 a physical therapist to provide physical therapy services. (3) (a) An accident and health insurance policy that provides coverage for physical therapy services may not impose a copayment, coinsurance, or office visit deductible for a covered physical therapy visit that exceeds the copayment, coinsurance, or office visit deductible applicable to a visit with a primary care provider. (b) Subsection (3)(a) applies to a health benefit plan renewed or entered into on or after January 1, 2027. (4) An accident and health insurance policy shall clearly state in literature explaining the policy the options available to insureds under Subsections (1) and (2). (5) 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. (6) 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.1/1/2027 (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: (a) (i) an obstetrician; (ii) a gynecologist; (iii) a pediatrician; or (iv) a physician assistant who has trained in a primary care physician's office and completed the physician assistant's collaboration requirement described in Section 58-70a-307; and (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 (6), 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 a physical therapist to provide physical therapy services. (3) (a) An accident and health insurance policy that provides coverage for physical therapy services may not impose a copayment, coinsurance, or office visit deductible for a covered physical therapy visit that exceeds the copayment, coinsurance, or office visit deductible applicable to a visit with a primary care provider. (b) Subsection (3)(a) applies to a health benefit plan renewed or entered into on or after January 1, 2027. (4) An accident and health insurance policy shall clearly state in literature explaining the policy the options available to insureds under Subsections (1) and (2). (5) 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. (6) 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.