SB 80 — Direct Primary Care Agreements

Florida Senate - 2018 CS for SB 80 By Senatorthe LeeCommittee 20-00216A-18on 201880__Banking Aand billInsurance; to be entitled An act relating to direct primary care;

and Senator Lee 597-00751-18 201880c1 A bill to be entitled An act relating to direct primary care agreements;

456.0625, F.S.;

defining terms;

authorizing primary care providers or their agents to enter into direct primary care agreements for providing primary care services;

providing applicability;

specifying requirements for direct primary care agreements;

creating s.

providing constructiondefinitions; and applicability of the Florida Insurance Code as to direct primary care agreements;

providingspecifying anthat exceptiona fordirect primary care providersagreement ordoes theirnot agentsconstitute frominsurance certainand requirementsis undernot thesubject codeto underthe certainFlorida circumstances;Insurance Code;

specifying that entering into a direct primary care agreement does not constitute the business of insurance and is not subject to the code;

providing that a certificate of authority or a license under the code is not required to market, sell, or offer to sell a direct primary care agreement;

specifying requirements for a direct primary care agreement;

17 Section 1. Section 456.0625,624.27, Florida Statutes, is created to read:

456.0625 Direct624.27 Direct primary care agreements.—agreements; (1) As used in this section, the term:

(a) “Directexemption primaryfrom carecode.— agreement”(1) As meansused ain contractthis betweensection, a primary care provider and a patient, the patient’sterm: legal representative, or an employer which meets the requirements specified under subsection (3) and which does not indemnify for services provided by a third party.

(b) “Primary(a) “Direct primary care provider”agreement” means a healthcontract carebetween practitionera licensedprimary undercare chapterprovider 458,and chaptera 459,patient, chaptera 460,patient’s orlegal chapterrepresentative, 464 or a primarypatient’s careemployer, groupwhich practicemeets thatthe providesrequirements medicalof servicessubsection to(4) patientsand whichdoes arenot commonlyindemnify providedfor withoutservices referralprovided fromby anothera healththird careparty. provider.

(c) “Primary(b) “Primary care service”provider” means thea screening,health assessment,care diagnosis,provider andlicensed treatmentunder ofchapter a458, patientchapter for459, thechapter purpose460, of promoting health or detectingchapter and464, managing disease or injurya withinprimary thecare competencygroup andpractice, trainingwho ofprovides the primary care provider.services to patients.

(2) A(c) “Primary primary care providerservices” ormeans anthe agentscreening, assessment, diagnosis, and treatment of a patient conducted within the competency and training of the primary care provider mayfor enterthe intopurpose aof directpromoting primaryhealth careor agreementdetecting forand providingmanaging primarydisease careor services.injury.

Section(2) A 624.27direct appliesprimary tocare aagreement directdoes primarynot careconstitute agreement.insurance and is not subject to the Florida Insurance Code.

(3) AThe act of entering into a direct primary care agreement must:does not constitute the business of insurance and is not subject to the Florida Insurance Code.

(3) A primary care provider or an agent of a primary care provider is not required to obtain a certificate of authority or license under the Florida Insurance Code to market, sell, or offer to sell a direct primary care agreement.

(4) For purposes of this section, a direct primary care agreement must:

(b) Be signed by the primary care provider or an agent of the primary care provider and the patient, the patient’s legal representative, or anthe patient’s employer.

(g) Offer a refund to the patientpatient, the patient’s legal representative, or the patient’s employer of monthly fees paid in advance if the primary care provider ceases to offer primary care services for any reason.

(h) Contain, in contrasting color and in notat lessleast than12-point 12 point type, the following statementsstatement on the samesignature pagepage: as the applicant’s signature:

1. This“This agreement is not health insurance,insurance and the primary care provider will not file any claims against the patient’s health insurance policy or plan for reimbursement of any primary care services covered by thisthe agreement.

2. ThisThis agreement does not qualify as minimum essential coverage to satisfy the individual shared responsibility provision of the federal Patient Protection and Affordable Care Act, Pub.26 U.S.C.

L.s.

No.5000A.

111-148.This agreement is not workers’ compensation insurance and does not replace an employer’s obligations under chapter 440, Florida Statutes.” Section 2. This act shall take effect July 1, 2018.

3. This agreement is not workers’ compensation insurance and may not replace the employer’s obligations under chapter 440.

Section 2. Section 624.27, Florida Statutes, is created to read:

624.27 Application of code as to direct primary care agreements.— (1) A direct primary care agreement, as defined in s.

456.0625, does not constitute insurance and is not subject to any chapter of the Florida Insurance Code.

The act of entering into a direct primary care agreement does not constitute the business of insurance and is not subject to any chapter of the Florida Insurance Code.

(2) A primary care provider or an agent of a primary care provider is not required to obtain a certificate of authority or license under any chapter of the Florida Insurance Code to market, sell, or offer to sell a direct primary care agreement pursuant to s.

456.0625.

Section 3. This act shall take effect July 1, 2018.