A bill that would specify the requirements of a direct primary care agreement and clarify that direct primary care agreements are not insurance was given first-round approval March 8.
Ralston Sen. Merv Riepe, introducer of LB817, said the proposal would provide clear legislative guidance for the state Department of Insurance that direct primary care agreements do not constitute insurance or function as a qualified health plan pursuant to any federal mandate.
“The need for this legislation is to guarantee in statute that direct primary care is not insurance and therefore exempt from insurance codes,” Riepe said.
Direct primary care is a medical care delivery model involving a contract between a patient and a primary care practitioner in which the patient pays a monthly retainer for unlimited office visits and an annual physical exam, he said. Generally, patients also obtain an insurance plan for major medical expenses, he said.
Under the bill, a practitioner in a direct primary care agreement would be prohibited from billing a patient in any form for primary care services provided under the contract. It also would require a practitioner to provide 60 days’ notice in advance of any changes to the contract.
“Fee-for-service health care is not working in the United States, and that includes Nebraska,” Riepe said. “The key to bending the health care cost curve is to refocus on direct primary care.”
Gering Sen. John Stinner supported the bill, saying direct primary care creates better options for providers and patients. For example, he said, doctors can escape the “blizzard” of paperwork that comes with billing insurance companies for routine care and instead focus on their patients.
Sen. Robert Hilkemann of Omaha agreed, calling the bill “innovative, outside the box thinking.” Patients would not be mandated to seek direct primary care, he said, but those who do would experience a simplified process.
“It will lead to better health outcomes,” he said. “Certainly, the research has shown that.”
LB817 advanced to select file on a 38-0 vote.