Direct health care agreements; exemption from code.

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(1) As used in this section, the term:

(a) “Direct health care agreement” means a contract between a health care provider and a patient, a patient’s legal representative, or a patient’s employer, which meets the requirements of subsection (4) and does not indemnify for services provided by a third party.

(b) “Health care provider” means a health care provider licensed under chapter 458, chapter 459, chapter 460, chapter 461, chapter 464, or chapter 466, or a health care group practice, who provides health care services to patients.

(c) “Health care services” means the screening, assessment, diagnosis, and treatment of a patient conducted within the competency and training of the health care provider for the purpose of promoting health or detecting and managing disease or injury.

(2) A direct health care agreement does not constitute insurance and is not subject to the Florida Insurance Code. The act of entering into a direct health care agreement does not constitute the business of insurance and is not subject to the Florida Insurance Code.

(3) A health care provider or an agent of a health care provider is not required to obtain a certificate of authority or license under the Florida Insurance Code to market, sell, or offer to sell a direct health care agreement.

(4) For purposes of this section, a direct health care agreement must:

(a) Be in writing.

(b) Be signed by the health care provider or an agent of the health care provider and the patient, the patient’s legal representative, or the patient’s employer.

(c) Allow a party to terminate the agreement by giving the other party at least 30 days’ advance written notice. The agreement may provide for immediate termination due to a violation of the physician-patient relationship or a breach of the terms of the agreement.

(d) Describe the scope of health care services that are covered by the monthly fee.

(e) Specify the monthly fee and any fees for health care services not covered by the monthly fee.

(f) Specify the duration of the agreement and any automatic renewal provisions.

(g) Offer a refund to the patient, the patient’s legal representative, or the patient’s employer of monthly fees paid in advance if the health care provider ceases to offer health care services for any reason.

(h) Contain, in contrasting color and in at least 12-point type, the following statement on the signature page: “This agreement is not health insurance and the health care provider will not file any claims against the patient’s health insurance policy or plan for reimbursement of any health care services covered by the agreement. This agreement does not qualify as minimum essential coverage to satisfy the individual shared responsibility provision of the Patient Protection and Affordable Care Act, 26 U.S.C. s. 5000A. This agreement is not workers’ compensation insurance and does not replace an employer’s obligations under chapter 440.”

History.—s. 1, ch. 2018-89; s. 1, ch. 2019-105; s. 11, ch. 2019-138; s. 3, ch. 2021-136.


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