Florida Senate - 2018                                      SB 80
       By Senator Lee
       20-00216A-18                                            201880__
    1                        A bill to be entitled                      
    2         An act relating to direct primary care; creating s.
    3         456.0625, F.S.; defining terms; authorizing primary
    4         care providers or their agents to enter into direct
    5         primary care agreements for providing primary care
    6         services; providing applicability; specifying
    7         requirements for direct primary care agreements;
    8         creating s. 624.27, F.S.; providing construction and
    9         applicability of the Florida Insurance Code as to
   10         direct primary care agreements; providing an exception
   11         for primary care providers or their agents from
   12         certain requirements under the code under certain
   13         circumstances; providing an effective date.
   15  Be It Enacted by the Legislature of the State of Florida:
   17         Section 1. Section 456.0625, Florida Statutes, is created
   18  to read:
   19         456.0625 Direct primary care agreements.—
   20         (1) As used in this section, the term:
   21         (a) “Direct primary care agreement” means a contract
   22  between a primary care provider and a patient, the patient’s
   23  legal representative, or an employer which meets the
   24  requirements specified under subsection (3) and which does not
   25  indemnify for services provided by a third party.
   26         (b) “Primary care provider” means a health care
   27  practitioner licensed under chapter 458, chapter 459, chapter
   28  460, or chapter 464 or a primary care group practice that
   29  provides medical services to patients which are commonly
   30  provided without referral from another health care provider.
   31         (c) “Primary care service” means the screening, assessment,
   32  diagnosis, and treatment of a patient for the purpose of
   33  promoting health or detecting and managing disease or injury
   34  within the competency and training of the primary care provider.
   35         (2) A primary care provider or an agent of the primary care
   36  provider may enter into a direct primary care agreement for
   37  providing primary care services. Section 624.27 applies to a
   38  direct primary care agreement.
   39         (3)A direct primary care agreement must:
   40         (a) Be in writing.
   41         (b) Be signed by the primary care provider or an agent of
   42  the primary care provider and the patient, the patient’s legal
   43  representative, or an employer.
   44         (c) Allow a party to terminate the agreement by giving the
   45  other party at least 30 days’ advance written notice. The
   46  agreement may provide for immediate termination due to a
   47  violation of the physician-patient relationship or a breach of
   48  the terms of the agreement.
   49         (d) Describe the scope of primary care services that are
   50  covered by the monthly fee.
   51         (e) Specify the monthly fee and any fees for primary care
   52  services not covered by the monthly fee.
   53         (f) Specify the duration of the agreement and any automatic
   54  renewal provisions.
   55         (g) Offer a refund to the patient of monthly fees paid in
   56  advance if the primary care provider ceases to offer primary
   57  care services for any reason.
   58         (h) Contain, in contrasting color and in not less than 12
   59  point type, the following statements on the same page as the
   60  applicant’s signature:
   61         1. This agreement is not health insurance, and the primary
   62  care provider will not file any claims against the patient’s
   63  health insurance policy or plan for reimbursement of any primary
   64  care services covered by this agreement.
   65         2. This agreement does not qualify as minimum essential
   66  coverage to satisfy the individual shared responsibility
   67  provision of the federal Patient Protection and Affordable Care
   68  Act, Pub. L. No. 111-148.
   69         3. This agreement is not workers’ compensation insurance
   70  and may not replace the employer’s obligations under chapter
   71  440.
   72         Section 2. Section 624.27, Florida Statutes, is created to
   73  read:
   74         624.27 Application of code as to direct primary care
   75  agreements.—
   76         (1) A direct primary care agreement, as defined in s.
   77  456.0625, does not constitute insurance and is not subject to
   78  any chapter of the Florida Insurance Code. The act of entering
   79  into a direct primary care agreement does not constitute the
   80  business of insurance and is not subject to any chapter of the
   81  Florida Insurance Code.
   82         (2) A primary care provider or an agent of a primary care
   83  provider is not required to obtain a certificate of authority or
   84  license under any chapter of the Florida Insurance Code to
   85  market, sell, or offer to sell a direct primary care agreement
   86  pursuant to s. 456.0625.
   87         Section 3. This act shall take effect July 1, 2018.