A bill for an act
relating to health care; establishing direct primary care service agreements;
amending Minnesota Statutes 2022, sections 62A.01, by adding a subdivision;
62A.011, subdivision 3; proposing coding for new law in Minnesota Statutes,
chapter 62Q.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Minnesota Statutes 2022, section 62A.01, is amended by adding a subdivision
to read:
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(a) A direct primary care service
agreement under section 62Q.20 is not insurance and is not subject to this chapter. Entering
into a direct primary care service agreement is not the business of insurance and is not
subject to this chapter or chapter 60A.
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(b) A health care provider or agent of a health care provider is not required to obtain a
certificate of authority or license under this chapter or chapter 60A, 62C, 62D, or 62N, to
market, sell, or offer to sell a direct primary care service agreement that meets the
requirements of section 62Q.20.
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Minnesota Statutes 2022, section 62A.011, subdivision 3, is amended to read:
"Health plan" means a policy or certificate of accident and sickness
insurance as defined in section 62A.01 offered by an insurance company licensed under
chapter 60A; a subscriber contract or certificate offered by a nonprofit health service plan
corporation operating under chapter 62C; a health maintenance contract or certificate offered
by a health maintenance organization operating under chapter 62D; a health benefit certificate
offered by a fraternal benefit society operating under chapter 64B; or health coverage offered
by a joint self-insurance employee health plan operating under chapter 62H. Health plan
means individual and group coverage, unless otherwise specified. Health plan does not
include coverage that is:
(1) limited to disability or income protection coverage;
(2) automobile medical payment coverage;
(3) liability insurance, including general liability insurance and automobile liability
insurance, or coverage issued as a supplement to liability insurance;
(4) designed solely to provide payments on a per diem, fixed indemnity, or
non-expense-incurred basis, including coverage only for a specified disease or illness or
hospital indemnity or other fixed indemnity insurance, if the benefits are provided under a
separate policy, certificate, or contract for insurance; there is no coordination between the
provision of benefits and any exclusion of benefits under any group health plan maintained
by the same plan sponsor; and the benefits are paid with respect to an event without regard
to whether benefits are provided with respect to such an event under any group health plan
maintained by the same plan sponsor;
(5) credit accident and health insurance as defined in section 62B.02;
(6) designed solely to provide hearing, dental, or vision care;
(7) blanket accident and sickness insurance as defined in section 62A.11;
(8) accident-only coverage;
(9) a long-term care policy as defined in section 62A.46 or 62S.01;
(10) issued as a supplement to Medicare, as defined in sections 62A.3099 to 62A.44, or
policies, contracts, or certificates that supplement Medicare issued by health maintenance
organizations or those policies, contracts, or certificates governed by section 1833 or 1876,
section 1851, et seq.; or section 1860D-1, et seq., of title XVIII of the federal Social Security
Act, et seq., as amended;
(11) workers' compensation insurance;
(12) issued solely as a companion to a health maintenance contract as described in section
62D.12, subdivision 1a, so long as the health maintenance contract meets the definition of
a health plan;
(13) coverage for on-site medical clinics; deleted text begin or
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(14) coverage supplemental to the coverage provided under United States Code, title
10, chapter 55, Civilian Health and Medical Program of the Uniformed Services
(CHAMPUS)deleted text begin .deleted text end new text begin ; or
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(15) coverage provided under a direct primary care service agreement described under
section 62Q.20.
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(a) For purposes of this section, the following terms have
the meanings given.
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(b) "Direct primary care service agreement" or "direct agreement" means a written
agreement entered into between a direct primary care practice and a direct patient, or the
direct patient's legal representative, in which the primary care direct practice charges a direct
fee as consideration for being available to provide and for providing direct primary care
services to the direct patient.
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(c) "Direct fee" means a fee charged by a direct primary care practice as consideration
for being available to provide and for providing primary care services to a direct patient as
specified in the direct agreement.
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(d) "Direct patient" means an individual who is party to a direct agreement and is entitled
to receive primary care services under the direct agreement from the direct primary care
practice.
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(e) "Direct primary care practice" or "direct practice" means a primary care provider
who furnishes primary care services through a direct agreement.
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(f) "Primary care provider" means a physician who is licensed under chapter 147 or an
advanced practice registered nurse licensed under sections 148.171 to 148.285, authorized
to engage in independent practice, and who is qualified to provide primary care services.
This term includes an individual primary care provider or a group of primary care providers.
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(g) "Primary care services" means:
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(1) routine health care services including screening, assessment, diagnosis, and treatment
for the purpose of the promotion of health, and the detection and management of disease
or injury within the competency and training of the primary care provider;
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(2) medical supplies and prescription drugs that are administered or dispensed in the
primary care provider's office or clinic; and
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(3) laboratory work, including routine blood screening and routine pathology screening
performed by a laboratory that is either associated with the direct primary care practice, or
is not associated with the direct primary care practice, but has entered into a contract with
the practice to provide laboratory work without charging a fee to the patient for the laboratory
work.
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(a) To be considered
a direct primary care service agreement for purposes of this section, the direct agreement
must:
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(1) be in writing;
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(2) be signed by the primary care provider or agent of the primary care practice and the
direct patient or the patient's legal representative;
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(3) allow either party to terminate the direct agreement upon written notice to the other
party according to subdivision 3;
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(4) describe the scope of the primary care services that are to be covered under the direct
agreement;
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