Florida Senate - 2016 CS for SB 132 By the Committee on Health Policy; and Senators Grimsley and Gaetz 588-02883-16 2016132c1 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 31 practitioner licensed under chapter 458, chapter 459, chapter 32 460, or chapter 464, or a primary care group practice that 33 provides medical services to patients which are commonly 34 provided without referral from 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.