Senate Bill 4 aims to establish a legal framework for direct primary care agreements in Wisconsin, exempting them from traditional insurance laws. A direct primary care agreement is defined as a contract between a healthcare provider and a patient (or their representative) where the provider agrees to deliver primary care services for a specified subscription fee and duration. The bill outlines the requirements for a valid agreement, including that it must be in writing, signed by both parties, and include specific details about the services provided, subscription fees, and termination terms. Importantly, the agreement must clearly state that it is not health insurance and that patients are responsible for any services not covered by the subscription fee.

Additionally, the bill prohibits healthcare providers from declining to enter into or terminating a direct primary care agreement solely based on a patient's health status, with specific conditions under which a provider may refuse or terminate the agreement. These include reaching maximum patient capacity or the patient's medical condition being incompatible with the services offered. The bill also allows healthcare providers to participate in insurance networks, provided they comply with the terms set by the insurance carrier. Overall, this legislation seeks to promote direct primary care arrangements while ensuring transparency and protecting both patients and providers.