1.1 A bill for an act
1.2 relating to health care; establishing direct primary care service agreements;
1.3 amending Minnesota Statutes 2024, sections 62A.01, by adding a subdivision;
1.4 62A.011, subdivision 3; proposing coding for new law in Minnesota Statutes,
1.5 chapter 62Q.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2024, section 62A.01, is amended by adding a subdivision
1.8to read:
1.9 Subd. 5.Direct primary care service agreements.(a) A direct primary care service
1.10agreement under section 62Q.20 is not insurance and is not subject to this chapter. Entering
1.11into a direct primary care service agreement is not the business of insurance and is not
1.12subject to this chapter or chapter 60A.
1.13 (b) A health care provider or agent of a health care provider is not required to obtain a
1.14certificate of authority or license under this chapter or chapter 60A, 62C, 62D, or 62N to
1.15market, sell, or offer to sell a direct primary care service agreement that meets the
1.16requirements of section 62Q.20.
1.17 Sec. 2. Minnesota Statutes 2024, section 62A.011, subdivision 3, is amended to read:
1.18 Subd. 3.Health plan."Health plan" means a policy or certificate of accident and sickness
1.19insurance as defined in section 62A.01 offered by an insurance company licensed under
1.20chapter 60A; a subscriber contract or certificate offered by a nonprofit health service plan
1.21corporation operating under chapter 62C; a health maintenance contract or certificate offered
1.22by a health maintenance organization operating under chapter 62D; a health benefit certificate
1.23offered by a fraternal benefit society operating under chapter 64B; or health coverage offered
1Sec. 2.
REVISOR SGS/MI 25-0075601/21/25
State of Minnesota
This Document can be made available
in alternative formats upon request
HOUSE OF REPRESENTATIVES
H. F. No. 1724
NINETY-FOURTH SESSION
Authored by Gillman and McDonald02/27/2025
The bill was read for the first time and referred to the Committee on Commerce Finance and Policy 2.1by a joint self-insurance employee health plan operating under chapter 62H. Health plan
2.2means individual and group coverage, unless otherwise specified. Health plan does not
2.3include coverage that is:
2.4 (1) limited to disability or income protection coverage;
2.5 (2) automobile medical payment coverage;
2.6 (3) liability insurance, including general liability insurance and automobile liability
2.7insurance, or coverage issued as a supplement to liability insurance;
2.8 (4) designed solely to provide payments on a per diem, fixed indemnity, or
2.9non-expense-incurred basis, including coverage only for a specified disease or illness or
2.10hospital indemnity or other fixed indemnity insurance, if the benefits are provided under a
2.11separate policy, certificate, or contract for insurance; there is no coordination between the
2.12provision of benefits and any exclusion of benefits under any group health plan maintained
2.13by the same plan sponsor; and the benefits are paid with respect to an event without regard
2.14to whether benefits are provided with respect to such an event under any group health plan
2.15maintained by the same plan sponsor;
2.16 (5) credit accident and health insurance as defined in section 62B.02;
2.17 (6) designed solely to provide hearing, dental, or vision care;
2.18 (7) blanket accident and sickness insurance as defined in section 62A.11;
2.19 (8) accident-only coverage;
2.20 (9) a long-term care policy as defined in section 62A.46 or 62S.01;
2.21 (10) issued as a supplement to Medicare, as defined in sections 62A.3099 to 62A.44, or
2.22policies, contracts, or certificates that supplement Medicare issued by health maintenance
2.23organizations or those policies, contracts, or certificates governed by section 1833 or 1876,
2.24section 1851, et seq.; or section 1860D-1, et seq., of title XVIII of the federal Social Security
2.25Act, et seq., as amended;
2.26 (11) workers' compensation insurance;
2.27 (12) issued solely as a companion to a health maintenance contract as described in section
2.2862D.12, subdivision 1a, so long as the health maintenance contract meets the definition of
2.29a health plan;
2.30 (13) coverage for on-site medical clinics; or
2Sec. 2.
REVISOR SGS/MI 25-0075601/21/25 3.1 (14) coverage supplemental to the coverage provided under United States Code, title
3.210, chapter 55, Civilian Health and Medical Program of the Uniformed Services
3.3(CHAMPUS).; or
3.4 (15) coverage provided under a direct primary care service agreement described under
3.5section 62Q.20.
3.6 Sec. 3. [62Q.20] DIRECT PRIMARY CARE SERVICE AGREEMENT.
3.7 Subdivision 1.Definitions.(a) For purposes of this section, the following terms have
3.8the meanings given.
3.9 (b) "Direct fee" means a fee charged by a direct primary care practice as consideration
3.10for being available to provide and for providing primary care services to a direct patient as
3.11specified in the direct agreement.
3.12 (c) "Direct patient" means an individual who is party to a direct agreement and is entitled
3.13to receive primary care services under the direct agreement from the direct primary care
3.14practice.
3.15 (d) "Direct primary care practice" or "direct practice" means a primary care provider
3.16who furnishes primary care services through a direct agreement.
3.17 (e) "Direct primary care service agreement" or "direct agreement" means a written
3.18agreement entered into between a direct primary care practice and a direct patient, or the
3.19direct patient's legal representative, in which the primary care direct practice charges a direct
3.20fee as consideration for being available to provide and for providing direct primary care
3.21services to the direct patient.
3.22 (f) "Primary care provider" means a physician who is licensed under chapter 147 or an
3.23advanced practice registered nurse licensed under chapter 148, who is authorized to engage
3.24in independent practice, and who is qualified to provide primary care services. This term
3.25includes an individual primary care provider or a group of primary care providers.
3.26 (g) "Primary care services" means:
3.27 (1) routine health care services, including screening, assessment, diagnosis, and treatment
3.28for the purpose of the promotion of health, and the detection and management of disease
3.29or injury within the competency and training of the primary care provider;
3.30 (2) medical supplies and prescription drugs that are administered or dispensed in the
3.31primary care provider's office or clinic; and
3Sec. 3.
REVISOR SGS/MI 25-0075601/21/25 4.1 (3) laboratory work, including routine blood screening and routine pathology screening
4.2performed by a laboratory that is either associated with the direct primary care practice or
4.3is not associated with the direct primary care practice but has entered into a contract with
4.4the practice to provide laboratory work without charging a fee to the patient for the laboratory
4.5work.
4.6 Subd. 2.Direct primary care services agreement requirements.(a) To be considered
4.7a direct primary care service agreement for purposes of this section, the direct agreement
4.8must:
4.9 (1) be in writing;
4.10 (2) be signed by the primary care provider or agent of the primary care practice and the
4.11direct patient or the patient's legal representative;
4.12 (3) allow either party to terminate the direct agreement upon written notice to the other
4.13party according to subdivision 3;
4.14 (4) describe the scope of the primary care services that are to be covered under the direct
4.15agreement;
4.16 (5) specify the fee to be paid on a monthly basis or as specified in the direct agreement;
4.17 (6) specify the duration of the direct agreement; and
4.18 (7) not be subject to automatic renewal.
4.19 (b) The direct agreement must clearly state that a direct primary care service agreement:
4.20is not considered health insurance; does not meet the requirements of federal law mandating
4.21individuals to purchase health insurance; and the fees charged in the agreement may not be
4.22reimbursed or applied toward a deductible under a health plan offered through a health plan
4.23company.
4.24 Subd. 3.Acceptance and discontinuance of patients.(a) A direct practice may not
4.25decline to accept a new patient or discontinue care to an existing patient solely on the basis
4.26of the patient's health status. A direct practice may decline to accept a patient if:
4.27 (1) the practice has reached its maximum capacity;
4.28 (2) the patient's medical condition is such that the practice is unable to provide the level
4.29and type of primary care services the patient requires; or
4.30 (3) the patient has previously terminated a direct agreement with the direct practice
4.31within the preceding year.
4Sec. 3.
REVISOR SGS/MI 25-0075601/21/25 5.1 (b) A direct patient or the patient's legal representative may terminate a direct agreement
5.2for any reason by providing written notice to the direct practice. Termination of the direct
5.3agreement is effective the first day of the month following the month the termination notice
5.4is provided to the direct practice. A direct practice may subsequently decline to accept the
5.5direct patient as a patient if the patient has terminated a previous direct agreement with the
5.6direct practice within the preceding year.
5.7 (c) A direct practice may terminate the direct agreement only if the direct patient:
5.8 (1) fails to pay the monthly fee;
5.9 (2) has performed an act of fraud; or
5.10 (3) is abusive and presents an emotional or physical danger to the staff or other patients.
5.11The direct practice must promptly provide notice of termination to the direct patient or the
5.12patient's legal representative stating the reason for the termination and the effective date of
5.13the termination.
5.14 (d) Notwithstanding paragraph (c), a direct practice may also discontinue care to a direct
5.15patient if the direct practice discontinues operation as a direct primary care practice. Notice
5.16must be provided to the direct patient or the patient's legal representative specifying the
5.17effective date of termination. Notice must be sufficient to provide the patient with the
5.18opportunity to obtain care from another provider.
5.19 Subd. 4.Direct fees.(a) The direct fee charged must represent the total amount due for
5.20all primary care services specified in the direct agreement provided to the direct patient
5.21within the specified time period. The direct fee must not vary from patient to patient based
5.22on the patient's health status or sex. The direct fee may be paid by the direct patient, by the
5.23patient's legal representative, or on the patient's behalf by a third party. The direct fee may
5.24be billed at the end of each monthly period or may be paid in advance for a period not to
5.25exceed 12 months.
5.26 (b) If a patient chooses to pay the monthly fee in advance, the funds must be held by the
5.27direct practice in a trust account with the monthly fee paid to the direct practice as earned
5.28at the end of each month.
5.29 (c) Upon receipt of a written notice of termination of the direct agreement from a direct
5.30patient or the patient's legal representative, the direct practice must promptly refund the
5.31unearned amount of the direct fees held in trust. If the direct practice discontinues care for
5.32any reason described under subdivision 3, the direct practice must promptly refund to the
5.33direct patient the unearned amount of the direct fees held in trust and at a prorated amount
5Sec. 3.
REVISOR SGS/MI 25-0075601/21/25 6.1of the direct fee earned for the current month based on the date the notice for termination
6.2was sent to the direct patient or the direct patient's legal representative.
6.3 (d) A direct practice shall not increase the monthly fee that has been negotiated with an
6.4existing direct patient more frequently than on an annual basis. A direct practice must
6.5provide advance notice of at least 60 days to existing patients of any change in the direct
6.6fee.
6.7 Subd. 5.Conduct of business.(a) A direct practice must maintain appropriate accounts
6.8regarding payments made and services received by a direct patient and upon request provide
6.9any data requested to the direct patient or the patient's legal representative.
6.10 (b) A direct practice must not submit a claim for payment to a health plan company for
6.11a primary care service provided to a direct patient that is covered by a direct agreement.
6.12 (c) No person shall make, publish, or disseminate any false, deceptive, or misleading
6.13representation or advertising related to the business of a direct practice.
6.14 (d) No person shall make, issue, or circulate, or cause to be made, issued, or circulated,
6.15a misrepresentation of the terms of a direct agreement or the benefits or advantages promised,
6.16or use the name or title of a direct agreement misrepresenting the nature of the direct
6.17agreement.
6.18 Subd. 6.Other care not prohibited.A direct primary care practice is not prohibited
6.19from providing services to other patients under a separate contract with a health plan
6.20company.
6.21 Subd. 7.Enforcement.A violation of this section shall constitute unprofessional conduct
6.22and may be grounds for disciplinary action under chapters 147 and 148.
6Sec. 3.
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