{"data":{"id":"us-ut/utah-code-31a-22-628","jurisdiction":"us-ut","citation":"Utah Code § 31A-22-628","heading":"Standing referral to a specialist.","body":"(1) With respect to a health insurance policy or managed care organization contract that does not allow an insured to have direct access to a health care specialist, the insurer shall establish and implement a procedure by which an insured may obtain a standing referral to a health care specialist.\n(2) The procedure established under Subsection (1):\n(a) shall provide for a standing referral to a specialist if the insured's primary care provider determines, in consultation with the specialist, that the insured needs continuing care from the specialist; and\n(b) may require the insurer's approval of a treatment plan designed by the specialist, in consultation with the primary care provider and the insured, which may include:\n(i) a limit on the number of visits to the specialist;\n(ii) a time limit on the duration of the referral; and\n(iii) mandatory updates on the insured's condition.","path":["Title 31A Insurance Code","Chapter 31A-22 Contracts in Specific Lines","Part 31A-22-6 Accident and Health Insurance"],"source_url":"https://le.utah.gov/xcode/Title31A/Chapter22/31A-22-S628.html","current_through":"2026 General Session","vintage":"","retrieved_at":"2026-09-03T11:34:33Z","sha256":"4ac1fe5e4e88a5567a40c5674db2e14ecd5cd3e6561d1e59123f6325e70c42f9","source_id":"us-ut","stale":false,"prev":"us-ut/utah-code-31a-22-627.1","next":"us-ut/utah-code-31a-22-629"},"notice":"GroundRules: Original legal text. Not legal advice."}