Needing a referral (an assessment by a physician that something is medically appropriate) is not the same as needing preauthorization (insurance company agreein

Needing a referral (an assessment by a physician that something is medically appropriate) is not the same as needing preauthorization (insurance company agreeing to pay) but in any case hence the following "you have to go through your designated primary care provider". Many PPOs and public systems work in the same way, that's more about judicious and appropriate use of resources than payment authorization.