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District of Columbia · Through 2026-08-20 (D.C. Law 26-175)

D.C. Code § 44-302.02: Standing referrals to specialists.

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Where this section sits in the code
  1. Title 44. Charitable and Curative Institutions.
  2. Chapter 3. Grievance Procedures for Health Benefits Plans.
  3. Subchapter II. Access to Specialists as Primary Care Providers.

(a)

In general, subject to subsection (b) of this section, a health benefits plan shall permit a member to receive medically necessary or appropriate specialty care for more than one visit without having to obtain the insurer’s approval for subsequent visits authorized by a primary care provider.

(b)

Subsection (a) of this section shall not apply to specialty care if the insurer informs the member, orally and in writing, of any limitation on the choice of participating providers with respect to such care.

Collected 2026-08-29T05:44:07Z. Source file · JSON

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