AN ACT EXEMPTING MEDICAL DIRECT PRIMARY CARE FROM REGULATION BY THE DEPARTMENT OF INSURANCE. SL 2020-85. Enacted July 1, 2020. Effective July 1, 2020.
Bill Summaries: H 471 EXEMPT DIRECT PRIMARY CARE FROM DOI REGS. (NEW)
Summary date: Jul 2 2020 - View Summary
Summary date: Jun 3 2020 - View Summary
Senate amendment makes the following changes to the 2nd edition.
Amends new GS 58-3-8 as follows. Amends the definition of a medical direct primary care agreement to allow the contract to be between a primary care provider and a family, in addition to the already listed individual patient or an individual patient's legal representative. Requires a medical direct primary care agreement to be signed by the individual patient, an adult member of the family, or the individual patient's legal representative (was, by the patient or patient's legal representative only). Makes conforming changes.
Summary date: May 28 2020 - View Summary
Senate committee substitute deletes the content of the 1st edition and now provides the following.
Enacts GS 58-3-8 to expressly exclude medical direct primary care agreements from the scope of GS Chapter 58, Insurance. Defines medical direct primary care agreement to mean a contract between a primary care provider, as defined, and an individual patient or individual patient's legal representative in which the primary care provider agrees to provide primary care services, as defined, to the individual patient for a specified fee and specified period of time, without billing third parties or billing on a fee-for-service basis. Defines primary care provider to include an individual or other legal entity alone or with other professionally associated with the individual or other legal entity. Explicitly states that primary care providers and their agents are not required to be licensed or certified under GS Chapter 58 with regards to medical direct primary care agreements. Sets forth seven requirements of medical direct primary care agreements, including that the agreement be in writing, signed by the parties or their representatives, allow termination without notice by either party, specify the periodic fee and duration of the agreement, specify any automatic renewal periods, specify the primary care services included and covered, and prominently state that the agreement is not health insurance.
Changes the act's titles.
Summary date: Mar 26 2019 - View Summary
Requires the Secretary of the Department of Health and Human Services to establish a workgroup to examine current administrative requirements for mental health, intellectual/developmental disability, and substance use disorder providers and how best to integrate these requirements with similar administrative requirements for physical health providers in order to avoid duplication and enhance efficiency. Specifies membership of the workgroup. Requires the study to include a review of at least all of the 14 specified categories of requirements imposed on mental health, intellectual/developmental disability, and substance use disorder providers and physical health providers, including service delivery, facility licensure, medicaid enrollment, and audits. Requires the workgroup to identify the federal or State entity that created each requirement examined by the workgroup and provide a recommendation about whether that requirement should remain or be eliminated or redesigned, including State legislation, statutes, contractual requirements, federal Medicaid, and managed care law. Requires the workgroup to consider any requirement imposed on mental health, intellectual/developmental disability, and substance use disorder providers that: (1) is not federally mandated; (2) exceeds what is required for physical health; (3) does not add value to the delivery of behavioral health services; or (4) is unable to be incorporated into standard electronic health records or does not align with meaningful use of electronic health records.
Requires the Department of Health and Human Services to report the workgroup's findings by March 31, 2020, to the Joint Legislative Oversight Committee on Health and Human Services, the Joint Legislative Oversight Committee on Medicaid and NC Health Choice, and the Fiscal Research Division.