HCBA Lawyer Magazine Vol. 29, No. 4 | Page 42

direCT priMarY Care: noT insuranCe Health Care law Section Chairs: T.J. Ferrante – Foley & Lardner LLP & Kevin Rudolph – Shriners Hospitals for Children on March 23, 2018, Florida became the 24th state to pass legislation that D expressly exempts dpC agreements from the state’s insurance code. irect Primary Care (DPC) is an alternative health care model gaining traction in Florida and throughout the U.S. Unlike traditional health care models, DPC does not accept insurance but instead charges patient “members” a fixed monthly fee that covers a range of primary care services. On March 23, 2018, Florida became the 24th state to pass legislation that expressly exempts DPC agreements from the state’s insurance code. Under Florida’s DPC law, which went into effect on July 1, 2018, “A direct primary care agreement does not constitute insurance and is not subject to the Florida Insurance Code. The act of entering into a direct primary care agreement does not constitute the business of insurance and is not subject to the Florida Insurance Code.” Notably, because a DPC agreement is not considered “insurance,” DPC practices are not subject to often onerous Insurance Code requirements, such as obtaining a certificate of authority or license. See generally, §§ 624.401 et seq., Fla. Stat. DPC agreements cover preventative “primary care services,” which are defined under the statute to include “screening, assessment, diagnosis, and treatment of a patient conducted within the competency and training of the primary care provider for the purpose of promoting health or detecting and managing disease or injury.” Patients are still encouraged to obtain some form of insurance for potential catastrophic events, such as car accidents or life-threatening emergencies that fall outside the scope of primary care services. The law provides minimum requirements that must be included in a DPC agreement. Section 624.27, Florida Statutes, provides that DPC agreements must be in writing, must be signed by the primary care provider and the patient, patient’s employer, or patient’s legal representative, and must: • Provide a 30-day advanced notice termination provision. Agreement may also provide for immediate termination due to a violation of the physician-patient relationship or a breach of the terms of the agreement. • Describe the scope of primary care services that are covered by the monthly fee. • Specify the monthly fee and any fees for primary care services not covered by the monthly fee. • Specify the duration of the agreement and any automatic renewal provisions. Continued on page 41 interested in joining the hCba lawyer referral & information service? Call (813) 221-7780 or visit https://hillsbarlrs.com/pages/for-lawyers. 40 MAR - APR 2019 | HCBA LAWYER