609.05 Primary provider and referrals.
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609.05 Primary provider and referrals.
(1)Except as provided in subs.
(2)and
(3), a limited service health organization, preferred provider plan, or defined network plan shall permit its enrollees to choose freely among participating providers.
(2)Subject to s. 609.22
(4)and
(4m), a limited service health organization, preferred provider plan, or defined network plan may require an enrollee to designate a primary provider and to obtain health care services from the primary provider when reasonably possible.
(3)Except as provided in ss. 609.22
(4m), 609.65 , and 609.655 , a limited service health organization, preferred provider plan, or defined network plan may require an enrollee to obtain a referral from the primary provider designated under sub.
(2)to another participating provider prior to obtaining health care services from that participating provider.