Bill Text: TX SB1018 | 2015-2016 | 84th Legislature | Introduced
Bill Title: Relating to the provision of direct primary care.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2015-04-01 - Left pending in committee [SB1018 Detail]
Download: Texas-2015-SB1018-Introduced.html
| 84R10468 SCL-F | ||
| By: Hancock | S.B. No. 1018 | |
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| relating to the provision of direct primary care. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Chapter 162, Occupations Code, is amended by | ||
| adding Subchapter F to read as follows: | ||
| SUBCHAPTER F. DIRECT PRIMARY CARE | ||
| Sec. 162.251. DEFINITIONS. In this subchapter: | ||
| (1) "Direct fee" means a fee charged by a physician to | ||
| a patient or a patient's designee for primary medical care services | ||
| provided by, or to be provided by, the physician to the patient. | ||
| The term includes a fee in any form, including a: | ||
| (A) monthly retainer; | ||
| (B) membership fee; | ||
| (C) subscription fee; | ||
| (D) fee paid under a medical service agreement; | ||
| or | ||
| (E) fee for a service, visit, or episode of care. | ||
| (2) "Direct primary care" means a primary medical care | ||
| service provided by a physician to a patient in return for payment | ||
| in accordance with a direct fee. | ||
| (3) "Medical service agreement" means a signed written | ||
| agreement under which a physician agrees to provide direct primary | ||
| care services for a patient in exchange for a direct fee for a | ||
| period of time that is entered into by the physician and: | ||
| (A) the patient; | ||
| (B) the patient's legal representative, | ||
| guardian, or employer on behalf of the patient; or | ||
| (C) the patient's legal representative's or | ||
| guardian's employer on behalf of the patient. | ||
| (4) "Physician" includes a professional association | ||
| or professional limited liability company owned entirely by an | ||
| individual licensed under this subtitle. | ||
| (5) "Primary medical care service" means a routine or | ||
| general health care service of the type provided at the time a | ||
| patient seeks preventive care or first seeks health care services | ||
| for a specific health concern, is a patient's main source for | ||
| regular health care services, and includes: | ||
| (A) promoting and maintaining mental and | ||
| physical health and wellness; | ||
| (B) preventing disease; | ||
| (C) screening, diagnosing, and treating acute or | ||
| chronic conditions caused by disease, injury, or illness; | ||
| (D) providing patient counseling and education; | ||
| and | ||
| (E) providing a broad spectrum of preventive and | ||
| curative health care over a period of time. | ||
| Sec. 162.252. DIRECT PRIMARY CARE NOT INSURANCE. (a) A | ||
| physician providing direct primary care is not an insurer or health | ||
| maintenance organization, and the physician is not subject to | ||
| regulation by the Texas Department of Insurance for the direct | ||
| primary care. | ||
| (b) A medical service agreement is not health or accident | ||
| insurance or coverage under Title 8, Insurance Code, and is not | ||
| subject to regulation by the Texas Department of Insurance. | ||
| (c) A physician is not required to obtain a certificate of | ||
| authority under the Insurance Code to market, sell, or offer a | ||
| medical service agreement or provide direct primary care. | ||
| (d) A physician providing direct primary care does not | ||
| violate Section 1204.055, Insurance Code. | ||
| Sec. 162.253. INTERFERENCE PROHIBITED. (a) The board or | ||
| another state agency may not prohibit, interfere with, initiate a | ||
| legal or administrative proceeding against, or impose a fine or | ||
| penalty against: | ||
| (1) a physician solely because the physician provides | ||
| direct primary care; or | ||
| (2) a person solely because the person pays a direct | ||
| fee for direct primary care. | ||
| (b) A health insurer, health maintenance organization, or | ||
| health care provider as that term is defined by Section 105.001 may | ||
| not prohibit, interfere with, or initiate a legal proceeding | ||
| against: | ||
| (1) a physician solely because the physician provides | ||
| direct primary care; or | ||
| (2) a person solely because the person pays a direct | ||
| fee for direct primary care. | ||
| SECTION 2. This Act takes effect immediately if it receives | ||
| a vote of two-thirds of all the members elected to each house, as | ||
| provided by Section 39, Article III, Texas Constitution. If this | ||
| Act does not receive the vote necessary for immediate effect, this | ||
| Act takes effect September 1, 2015. | ||
