Reference is to the bill as introduced.
Amend the bill, as and if amended, by striking all after the enacting words and inserting:
SECTION 1. Chapter 61, Title 38 of the 1976 Code is amended by adding:
"Section 38-61-80.
(A) A direct primary care agreement is
not a contract of insurance in this State and is not subject to
regulation by the Department of Insurance.
(B) For purposes of
this section:
(1)
'Direct primary care agreement' or 'agreement' means a
written agreement between a patient or the patient's legal
representative and a direct primary care provider in which the
provider agrees to provide direct primary care services as
defined in this section.
(2)
'Direct primary care fee' or 'fee' means the fee charged
by a direct primary care provider or practice for being
available to provide and for providing direct primary care
services specified in the direct primary care agreement.
(3)
'Direct primary care services' means routine health care
services, such as:
(a)
screening, assessment, diagnosis, and treatment for the
purpose of promotion of health or the detection and management
of disease or injury;
(b)
provision of medical supplies and prescription drugs that
are prescribed or dispensed in a health care provider's office;
and
(c)
laboratory work including routine blood screening or
routine pathology screening performed by a laboratory meeting
the requirements of applicable state law.
(4)
'Direct primary care provider' means a physician who
provides direct primary care services in compliance with this
section and is licensed to practice medicine in this State under
Chapter 47, Title 40, or a practice of such physicians.
(C) The direct primary
care agreement must:
(1)
be in writing and signed by the patient or the patient's
legal representative and the direct primary care provider;
(2)
allow either party to terminate the agreement in writing,
without penalty or payment of a termination fee, by giving the
other party at least thirty days' advance notice;
(3)
describe the direct primary care services to be provided
in exchange for payment of a fee;
(4)
specify the amount of the monthly direct primary care fee
for providing direct primary care services under the direct
primary care agreement;
(5)
specify the amount of any additional fees or charges for
services to be provided that will not be covered by the direct
primary care fee;
(6)
prohibit the direct primary care provider from charging or
receiving additional compensation for health care services
included in the fee; and
(7)
conspicuously and prominently include on the front page of
the agreement the following notice initialed by the patient or
the patient's legal representative:
'THIS AGREEMENT DOES NOT CONSTITUTE INSURANCE AND IS NOT A
SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. THIS AGREEMENT COVERS
ONLY THE DIRECT PRIMARY CARE SERVICES DESCRIBED IN THIS
AGREEMENT. PATIENT WILL BE RESPONSIBLE TO PAY FOR SERVICES NOT
SPECIFIED IN THIS AGREEMENT. PATIENT MAY NOT FILE OR OTHERWISE
SUBMIT A CLAIM TO, OR RECEIVE REIMBURSEMENT FROM, ANY INSURER
FOR SERVICES PROVIDED IN ACCORDANCE WITH A DIRECT PRIMARY CARE
AGREEMENT.'
(D) Direct primary care
providers shall report to the Department of Consumer Affairs its
participation in a direct primary care practice. The form,
content, and procedure for this report must be developed in a
manner prescribed by the administrator of the Department of
Consumer Affairs and must specify, at a minimum, the name and
business address of the direct primary care practice and
participating physicians. The Department of Consumer Affairs
shall make publicly-available on its website a list of the names
and business addresses of all participating direct primary care
practices and physicians.
SECTION 2. This act takes effect upon approval by the Governor.
Renumber sections to conform.
Amend title to conform.