As used in this section:
(1) "Direct primary care agreement" means a written agreement that:
Is between a patient, his or her legal representative, a government entity, or a patient's employer and a direct primary health care provider;
Discloses and describes to the patient and to the person paying the direct primarycare fee the primary care services to be provided in exchange for payment of a periodic fee;
Specifies the periodic fee required and any additional fees that may be charged;
May allow the periodic fee and any additional fees to be paid by a third party;
Prohibits the provider from submitting a fee-for-service claim for payment to a healthinsurance issuer for primary care services covered under the agreement and states that some services may be a covered benefit or covered service under the patient's health benefit plan as defined in section 10-16-102, at no cost to the patient;
Conspicuously and prominently discloses to all parties subject to the agreement that itis not health insurance and does not meet any individual health benefit plan mandate that may be required by federal law and the patient is not entitled to health insurance protections for consumers under title 10; and
Allows either party to terminate the agreement, in writing and with notice, as specified in the agreement and subject to refund terms and conditions in the agreement.
"Direct primary health care provider" means an individual or legal entity that is licensed under article 240 of title 12 or part 1 of article 255 of title 12 to provide primary care services in this state and who enters into a direct primary care agreement. "Direct primary health care provider" includes an individual primary care provider or other legal entity, alone or with others professionally associated with the individual or other legal entity.
"Primary care service" includes the screening, assessment, diagnosis, and treatmentfor the purpose of promotion of health or the detection and management of disease or injury within the competency and training of the primary care provider.
Source: L. 2017: Entire article added, (HB 17-1115), ch. 151, p. 511, § 2, effective August 9. L. 2019: (2) amended, (HB 19-1172), ch. 136, p. 1646, § 16, effective October 1. L. 2020: (2) amended, (HB 20-1183), ch. 157, p. 695, § 31, effective July 1.