HF1724

HF1724 (Legislative Session 94 (2025-2026))

Direct primary care service agreements established.

Related bill: SF1288

AI Generated Summary

Purpose of the Bill

The bill aims to establish "direct primary care service agreements" in Minnesota, clarifying their status and setting guidelines for their operation. These agreements are defined as contracts directly between a patient and a primary care provider, where a set fee is paid in exchange for specific primary healthcare services.

Main Provisions

Exclusion from Insurance: Direct primary care agreements are distinguished from insurance, meaning they aren't regulated under insurance laws and providers don't need insurance licenses to offer them.
Agreement Requirements: Direct primary care agreements must be in writing, outline the services provided, and detail the direct fee. They cannot automatically renew, and must allow termination by either party with notice.
Provider and Patient Rights: While providers can't refuse patients based on health status, they can limit patients due to capacity, ability to meet care needs, or past termination of an agreement. Patients can terminate agreements at any time with notice.
Fee Structures: Payments under these agreements cover all specified primary care services and must be consistent regardless of the patient's health status or gender. Fees can be paid monthly or in advance.
Additional Guidelines: Providers are prohibited from billing health insurance for services covered under these agreements. Providers must also keep accurate records and avoid misleading advertising.

Significant Changes to Existing Law

Definitions Adjustment: The bill amends current law to explicitly define what constitutes a "health plan" and exclude direct primary care service agreements from this category.
Provision Flexibility: While establishing a legal framework for direct primary care services, the bill allows these practices to provide services outside such agreements under a separate health plan contract.
Disciplinary Actions: Violations of these guidelines can lead to disciplinary action under existing professional conduct regulations.

Relevant Terms

Direct Primary Care
Health Plan
Insurance Regulation
Primary Care Provider
Direct Fee
Patient Rights
Termination of Agreement

Bill text versions

Introduction PDF file

Actions

Date	Chamber	Where	Type	Name	Committee Name
February 26, 2025	House	Floor	Action	Introduction and first reading, referred to	Commerce Finance and Policy

Citations

[
  {
    "analysis": {
      "added": [
        "Direct primary care service agreements are not considered insurance."
      ],
      "removed": [
        "No specifics were removed."
      ],
      "summary": "The bill establishes definitions and clarifications for direct primary care service agreements under section 62A.01.",
      "modified": [
        "Modifies understanding of agreements in relation to insurance requirements."
      ]
    },
    "citation": "62A.01"
  },
  {
    "analysis": {
      "added": [
        "Clarifies what a health plan means and what is excluded."
      ],
      "removed": [
        "N/A"
      ],
      "summary": "Amendments define what constitutes a health plan and exclude specific services.",
      "modified": [
        "Health plans do not include direct primary care service agreements."
      ]
    },
    "citation": "62A.011"
  },
  {
    "analysis": {
      "added": [
        "Exclusion of certain types of coverage as not part of health plan."
      ],
      "removed": [
        "N/A"
      ],
      "summary": "References blanket accident and sickness insurance as not constituting a health plan.",
      "modified": [
        "Includes blanket accident and sickness insurance in list of exclusions."
      ]
    },
    "citation": "62A.11"
  },
  {
    "analysis": {
      "added": [
        "Reinforces exclusions of long-term care policies."
      ],
      "removed": [
        "N/A"
      ],
      "summary": "The bill references long-term care policies under exclusions from definition of health plans.",
      "modified": [
        "Clarifies exclusions within health plan definitions."
      ]
    },
    "citation": "62A.46"
  },
  {
    "analysis": {
      "added": [
        "References sections detailing Medicare supplemental policies."
      ],
      "removed": [
        "N/A"
      ],
      "summary": "Exclusions to definition of health plan for Medicare supplements.",
      "modified": [
        "Clarifies exclusion criteria for what is not a health plan."
      ]
    },
    "citation": "62A.3099 to 62A.44"
  },
  {
    "analysis": {
      "added": [
        "Defines and excludes credit accident/health insurance."
      ],
      "removed": [
        "N/A"
      ],
      "summary": "Credit accident and health insurance defined and excluded as health plan.",
      "modified": [
        "Aligns exclusion with accepted definitions of insurance types."
      ]
    },
    "citation": "62B.02"
  },
  {
    "analysis": {
      "added": [
        "Details contract requirements for health maintenance exclusions."
      ],
      "removed": [
        "N/A"
      ],
      "summary": "Specifies health maintenance contract conditions and exclusions.",
      "modified": [
        "Clarifies maintenance contracts in health plan contexts."
      ]
    },
    "citation": "62D.12"
  },
  {
    "analysis": {
      "added": [
        "Federal acts providing Medicare definitions and exclusions."
      ],
      "removed": [
        "N/A"
      ],
      "summary": "Federal Social Security Act sections relating to Medicare are cited and excluded from the health plan definition.",
      "modified": [
        "Clarified exclusions based on federal Medicare guidelines."
      ]
    },
    "citation": "1833 or 1876 or 1851 et seq. or 1860D-1 et seq. of title XVIII of the federal Social Security Act"
  },
  {
    "analysis": {
      "added": [
        "Inclusion of federal military health program exclusions."
      ],
      "removed": [
        "N/A"
      ],
      "summary": "Exclusion of CHAMPUS-related coverage from health plan definition.",
      "modified": [
        "Refines exclusion list for health plan definitions and coverage."
      ]
    },
    "citation": "10 U.S. Code Chapter 55"
  }
]