Christine Jordan Sexton
Doctors and nurses could charge patients a set fee and provide services in exchange for that price and not be afoul of the state’s insurance codes under a proposed committee bill unveiled by the House Innovations Subcommittee.
The proposed committee bill — PCB HIS 15-02 — allows osteopathic doctors, medical doctors and nurses to provide primary care services in exchange for a set fee without having to obtain a certificate of authority from the Office of Insurance Regulation.
While the bill makes clear a primary-care agreement is not an insurance policy, the bill does place in insurance code the requirements for direct primary-care contracts. The contracts must be in writing and either party must have the ability to cancel the contracts. The contracts also must specify what services are covered by the fee.
The subcommittee last month heard from proponents of direct patient care, including Garrison Bliss, co-founder of Qliance in Washington, as well as Bill Herrle, executive director of the National Federation of Independent Business Florida.
House Speaker Steve Crisafulli said it’s an idea that he can support.
“I’m interested and supportive of the concept. If we are able to work on access to provide better care … let’s have those conversations,” Crisafulli said.
Direct primary care has morphed over the years from the initial model — which initially was pricey — upward of $20,000 annually and targeted toward well-to-do patients who liked the idea of not having to wait for medical appointments and having around-the-clock access to their doctor — to the more affordable product available today, which can cost between $50 and $150 annually.
The central tenet behind the delivery model is that doctors aren’t charging insurance companies for primary care services. Not involving a third party frees the doctors from the paperwork and billing insurance companies require.
Patients are encouraged to have insurance for major medical events that require a hospitalization.
