Florida Senate - 2016                                     SB 132
       
       
        
       By Senator Grimsley
       
       
       
       
       
       21-00052-16                                            2016132__
    1                        A bill to be entitled                      
    2         An act relating to direct primary care; creating s.
    3         624.27, F.S.; defining terms; specifying that a direct
    4         primary care agreement does not constitute insurance
    5         and is not subject to ch. 636, F.S., relating to
    6         prepaid limited health service organizations and
    7         discount medical plan organizations, or any other
    8         chapter of the Florida Insurance Code; specifying that
    9         entering into a direct primary care agreement does not
   10         constitute the business of insurance and is not
   11         subject to ch. 636, F.S., or any other chapter of the
   12         code; providing that certain certificates of authority
   13         and licenses are not required to market, sell, or
   14         offer to sell a direct primary care agreement;
   15         specifying requirements for a direct primary care
   16         agreement; providing an effective date.
   17          
   18  Be It Enacted by the Legislature of the State of Florida:
   19  
   20         Section 1. Section 624.27, Florida Statutes, is created to
   21  read:
   22         624.27 Application of code as to direct primary care
   23  agreements.—
   24         (1) As used in this section, the term:
   25         (a) “Direct primary care agreement” means a contract
   26  between a primary care provider and a patient, the patient’s
   27  legal representative, or an employer which meets the
   28  requirements specified under subsection (4) and does not
   29  indemnify for services provided by a third party.
   30         (b) “Primary care provider” means a health care provider
   31  licensed under chapter 458, chapter 459, or chapter 464, or a
   32  primary care group practice that provides medical services to
   33  patients which are commonly provided without referral from
   34  another health care provider.
   35         (c) “Primary care service” means the screening, assessment,
   36  diagnosis, and treatment of a patient for the purpose of
   37  promoting health or detecting and managing disease or injury
   38  within the competency and training of the primary care provider.
   39         (2) A direct primary care agreement does not constitute
   40  insurance and is not subject to chapter 636 or any other chapter
   41  of the Florida Insurance Code. The act of entering into a direct
   42  primary care agreement does not constitute the business of
   43  insurance and is not subject to chapter 636 or any other chapter
   44  of the Florida Insurance Code.
   45         (3) A primary care provider or an agent of a primary care
   46  provider is not required to obtain a certificate of authority or
   47  license under chapter 636 or any other chapter of the Florida
   48  Insurance Code to market, sell, or offer to sell a direct
   49  primary care agreement.
   50         (4) For purposes of this section, a direct primary care
   51  agreement must:
   52         (a) Be in writing.
   53         (b) Be signed by the primary care provider or an agent of
   54  the primary care provider and the patient, the patient’s legal
   55  representative, or an employer.
   56         (c) Allow a party to terminate the agreement by written
   57  notice to the other party after a period specified in the
   58  agreement.
   59         (d) Describe the scope of primary care services that are
   60  covered by the monthly fee.
   61         (e) Specify the monthly fee and any fees for primary care
   62  services not covered by the monthly fee.
   63         (f) Specify the duration of the agreement and any automatic
   64  renewal provisions.
   65         (g) Offer a refund to the patient of monthly fees paid in
   66  advance if the primary care provider ceases to offer primary
   67  care services for any reason.
   68         (h) State that the agreement is not health insurance and
   69  that the primary care provider will not file any claims against
   70  the patient’s health insurance policy or plan for reimbursement
   71  for any primary care services covered by the agreement.
   72         (i) State that the agreement does not qualify as minimum
   73  essential coverage to satisfy the individual shared
   74  responsibility provision of the Patient Protection and
   75  Affordable Care Act pursuant to 26 U.S.C. s. 5000A.
   76         Section 2. This act shall take effect July 1, 2016.