(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 (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.
Amended by Chapter 69, 2026 General Session