31A-4-106 - Provision of health care. - Utah Statutes

31A-4-106. Provision of health care.
(1) As used in this section, "health care provider" has the same definition as in Section78B-3-403.
(2) Except under Subsection (3) or (4), unless authorized to do so or employed bysomeone authorized to do so under Chapter 5, 7, 8, 9, or 14, a person may not:
(a) directly or indirectly provide health care;
(b) arrange for health care;
(c) manage or administer the provision or arrangement of health care;
(d) collect advance payments for health care; or
(e) compensate a provider of health care.
(3) Subsection (2) does not apply to:
(a) a natural person or professional corporation that alone or with others professionallyassociated with the natural person or professional corporation, and without receivingconsideration for services in advance of the need for a particular service, provides the servicepersonally with the aid of nonprofessional assistants;
(b) a health care facility as defined in Section 26-21-2 that:
(i) is licensed or exempt from licensing under Title 26, Chapter 21, Health Care FacilityLicensing and Inspection Act; and
(ii) does not engage in health care insurance as defined under Section 31A-1-301;
(c) a person who files with the commissioner a certificate from the United StatesDepartment of Labor, or other evidence satisfactory to the commissioner, showing that the lawsof Utah are preempted under Section 514 of the Employee Retirement Income Security Act of1974 or other federal law;
(d) a person licensed under Chapter 23a, Insurance Marketing - Licensing Producers,Consultants, and Reinsurance Intermediaries, who:
(i) arranges for the insurance of all services under:
(A) Subsection (2) by an insurer authorized to do business in Utah; or
(B) Section 31A-15-103; or
(ii) works for an uninsured employer that complies with Chapter 13, Employee WelfareFunds and Plans; or
(e) an employer that self-funds its obligations to provide health care services orindemnity for its employees if the employer complies with Chapter 13, Employee Welfare Fundsand Plans.
(4) A person may not provide administrative or management services for another personsubject to Subsection (2) and not exempt under Subsection (3) unless the person:
(a) is an authorized insurer under Chapter 5, 7, 8, 9, or 14; or
(b) complies with Chapter 25, Third Party Administrators.
(5) An insurer or person who provides, administers, or manages health care insuranceunder Chapter 5, 7, 8, 9, or 14 may not enter into a contract that limits a health care provider'sability to advise the health care provider's patients or clients fully about treatment options orother issues that affect the health care of the health care provider's patients or clients.

Amended by Chapter 3, 2008 General Session
Amended by Chapter 345, 2008 General Session