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  84R10468 SCL-F
 
  By: Bonnen of Galveston H.B. No. 1945
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  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.