Minnesota 2025-2026 Regular Session

Minnesota House Bill HF1724 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1.1 A bill for an act
2	2	1.2 relating to health care; establishing direct primary care service agreements;
3	3	1.3 amending Minnesota Statutes 2024, sections 62A.01, by adding a subdivision;
4	4	1.4 62A.011, subdivision 3; proposing coding for new law in Minnesota Statutes,
5	5	1.5 chapter 62Q.
6	6	1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
7	7	1.7 Section 1. Minnesota Statutes 2024, section 62A.01, is amended by adding a subdivision
8	8	1.8to read:
9	9	1.9 Subd. 5.Direct primary care service agreements.(a) A direct primary care service
10	10	1.10agreement under section 62Q.20 is not insurance and is not subject to this chapter. Entering
11	11	1.11into a direct primary care service agreement is not the business of insurance and is not
12	12	1.12subject to this chapter or chapter 60A.
13	13	1.13 (b) A health care provider or agent of a health care provider is not required to obtain a
14	14	1.14certificate of authority or license under this chapter or chapter 60A, 62C, 62D, or 62N to
15	15	1.15market, sell, or offer to sell a direct primary care service agreement that meets the
16	16	1.16requirements of section 62Q.20.
17	17	1.17 Sec. 2. Minnesota Statutes 2024, section 62A.011, subdivision 3, is amended to read:
18	18	1.18 Subd. 3.Health plan."Health plan" means a policy or certificate of accident and sickness
19	19	1.19insurance as defined in section 62A.01 offered by an insurance company licensed under
20	20	1.20chapter 60A; a subscriber contract or certificate offered by a nonprofit health service plan
21	21	1.21corporation operating under chapter 62C; a health maintenance contract or certificate offered
22	22	1.22by a health maintenance organization operating under chapter 62D; a health benefit certificate
23	23	1.23offered by a fraternal benefit society operating under chapter 64B; or health coverage offered
24	24	1Sec. 2.
25	25	REVISOR SGS/MI 25-0075601/21/25
26	26	State of Minnesota
27	27	This Document can be made available
28	28	in alternative formats upon request
29	29	HOUSE OF REPRESENTATIVES
30	30	H. F. No. 1724
31	31	NINETY-FOURTH SESSION
32	32	Authored by Gillman and McDonald02/27/2025
33	33	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
34	34	2.2means individual and group coverage, unless otherwise specified. Health plan does not
35	35	2.3include coverage that is:
36	36	2.4 (1) limited to disability or income protection coverage;
37	37	2.5 (2) automobile medical payment coverage;
38	38	2.6 (3) liability insurance, including general liability insurance and automobile liability
39	39	2.7insurance, or coverage issued as a supplement to liability insurance;
40	40	2.8 (4) designed solely to provide payments on a per diem, fixed indemnity, or
41	41	2.9non-expense-incurred basis, including coverage only for a specified disease or illness or
42	42	2.10hospital indemnity or other fixed indemnity insurance, if the benefits are provided under a
43	43	2.11separate policy, certificate, or contract for insurance; there is no coordination between the
44	44	2.12provision of benefits and any exclusion of benefits under any group health plan maintained
45	45	2.13by the same plan sponsor; and the benefits are paid with respect to an event without regard
46	46	2.14to whether benefits are provided with respect to such an event under any group health plan
47	47	2.15maintained by the same plan sponsor;
48	48	2.16 (5) credit accident and health insurance as defined in section 62B.02;
49	49	2.17 (6) designed solely to provide hearing, dental, or vision care;
50	50	2.18 (7) blanket accident and sickness insurance as defined in section 62A.11;
51	51	2.19 (8) accident-only coverage;
52	52	2.20 (9) a long-term care policy as defined in section 62A.46 or 62S.01;
53	53	2.21 (10) issued as a supplement to Medicare, as defined in sections 62A.3099 to 62A.44, or
54	54	2.22policies, contracts, or certificates that supplement Medicare issued by health maintenance
55	55	2.23organizations or those policies, contracts, or certificates governed by section 1833 or 1876,
56	56	2.24section 1851, et seq.; or section 1860D-1, et seq., of title XVIII of the federal Social Security
57	57	2.25Act, et seq., as amended;
58	58	2.26 (11) workers' compensation insurance;
59	59	2.27 (12) issued solely as a companion to a health maintenance contract as described in section
60	60	2.2862D.12, subdivision 1a, so long as the health maintenance contract meets the definition of
61	61	2.29a health plan;
62	62	2.30 (13) coverage for on-site medical clinics; or
63	63	2Sec. 2.
64	64	REVISOR SGS/MI 25-0075601/21/25 3.1 (14) coverage supplemental to the coverage provided under United States Code, title
65	65	3.210, chapter 55, Civilian Health and Medical Program of the Uniformed Services
66	66	3.3(CHAMPUS).; or
67	67	3.4 (15) coverage provided under a direct primary care service agreement described under
68	68	3.5section 62Q.20.
69	69	3.6 Sec. 3. [62Q.20] DIRECT PRIMARY CARE SERVICE AGREEMENT.
70	70	3.7 Subdivision 1.Definitions.(a) For purposes of this section, the following terms have
71	71	3.8the meanings given.
72	72	3.9 (b) "Direct fee" means a fee charged by a direct primary care practice as consideration
73	73	3.10for being available to provide and for providing primary care services to a direct patient as
74	74	3.11specified in the direct agreement.
75	75	3.12 (c) "Direct patient" means an individual who is party to a direct agreement and is entitled
76	76	3.13to receive primary care services under the direct agreement from the direct primary care
77	77	3.14practice.
78	78	3.15 (d) "Direct primary care practice" or "direct practice" means a primary care provider
79	79	3.16who furnishes primary care services through a direct agreement.
80	80	3.17 (e) "Direct primary care service agreement" or "direct agreement" means a written
81	81	3.18agreement entered into between a direct primary care practice and a direct patient, or the
82	82	3.19direct patient's legal representative, in which the primary care direct practice charges a direct
83	83	3.20fee as consideration for being available to provide and for providing direct primary care
84	84	3.21services to the direct patient.
85	85	3.22 (f) "Primary care provider" means a physician who is licensed under chapter 147 or an
86	86	3.23advanced practice registered nurse licensed under chapter 148, who is authorized to engage
87	87	3.24in independent practice, and who is qualified to provide primary care services. This term
88	88	3.25includes an individual primary care provider or a group of primary care providers.
89	89	3.26 (g) "Primary care services" means:
90	90	3.27 (1) routine health care services, including screening, assessment, diagnosis, and treatment
91	91	3.28for the purpose of the promotion of health, and the detection and management of disease
92	92	3.29or injury within the competency and training of the primary care provider;
93	93	3.30 (2) medical supplies and prescription drugs that are administered or dispensed in the
94	94	3.31primary care provider's office or clinic; and
95	95	3Sec. 3.
96	96	REVISOR SGS/MI 25-0075601/21/25 4.1 (3) laboratory work, including routine blood screening and routine pathology screening
97	97	4.2performed by a laboratory that is either associated with the direct primary care practice or
98	98	4.3is not associated with the direct primary care practice but has entered into a contract with
99	99	4.4the practice to provide laboratory work without charging a fee to the patient for the laboratory
100	100	4.5work.
101	101	4.6 Subd. 2.Direct primary care services agreement requirements.(a) To be considered
102	102	4.7a direct primary care service agreement for purposes of this section, the direct agreement
103	103	4.8must:
104	104	4.9 (1) be in writing;
105	105	4.10 (2) be signed by the primary care provider or agent of the primary care practice and the
106	106	4.11direct patient or the patient's legal representative;
107	107	4.12 (3) allow either party to terminate the direct agreement upon written notice to the other
108	108	4.13party according to subdivision 3;
109	109	4.14 (4) describe the scope of the primary care services that are to be covered under the direct
110	110	4.15agreement;
111	111	4.16 (5) specify the fee to be paid on a monthly basis or as specified in the direct agreement;
112	112	4.17 (6) specify the duration of the direct agreement; and
113	113	4.18 (7) not be subject to automatic renewal.
114	114	4.19 (b) The direct agreement must clearly state that a direct primary care service agreement:
115	115	4.20is not considered health insurance; does not meet the requirements of federal law mandating
116	116	4.21individuals to purchase health insurance; and the fees charged in the agreement may not be
117	117	4.22reimbursed or applied toward a deductible under a health plan offered through a health plan
118	118	4.23company.
119	119	4.24 Subd. 3.Acceptance and discontinuance of patients.(a) A direct practice may not
120	120	4.25decline to accept a new patient or discontinue care to an existing patient solely on the basis
121	121	4.26of the patient's health status. A direct practice may decline to accept a patient if:
122	122	4.27 (1) the practice has reached its maximum capacity;
123	123	4.28 (2) the patient's medical condition is such that the practice is unable to provide the level
124	124	4.29and type of primary care services the patient requires; or
125	125	4.30 (3) the patient has previously terminated a direct agreement with the direct practice
126	126	4.31within the preceding year.
127	127	4Sec. 3.
128	128	REVISOR SGS/MI 25-0075601/21/25 5.1 (b) A direct patient or the patient's legal representative may terminate a direct agreement
129	129	5.2for any reason by providing written notice to the direct practice. Termination of the direct
130	130	5.3agreement is effective the first day of the month following the month the termination notice
131	131	5.4is provided to the direct practice. A direct practice may subsequently decline to accept the
132	132	5.5direct patient as a patient if the patient has terminated a previous direct agreement with the
133	133	5.6direct practice within the preceding year.
134	134	5.7 (c) A direct practice may terminate the direct agreement only if the direct patient:
135	135	5.8 (1) fails to pay the monthly fee;
136	136	5.9 (2) has performed an act of fraud; or
137	137	5.10 (3) is abusive and presents an emotional or physical danger to the staff or other patients.
138	138	5.11The direct practice must promptly provide notice of termination to the direct patient or the
139	139	5.12patient's legal representative stating the reason for the termination and the effective date of
140	140	5.13the termination.
141	141	5.14 (d) Notwithstanding paragraph (c), a direct practice may also discontinue care to a direct
142	142	5.15patient if the direct practice discontinues operation as a direct primary care practice. Notice
143	143	5.16must be provided to the direct patient or the patient's legal representative specifying the
144	144	5.17effective date of termination. Notice must be sufficient to provide the patient with the
145	145	5.18opportunity to obtain care from another provider.
146	146	5.19 Subd. 4.Direct fees.(a) The direct fee charged must represent the total amount due for
147	147	5.20all primary care services specified in the direct agreement provided to the direct patient
148	148	5.21within the specified time period. The direct fee must not vary from patient to patient based
149	149	5.22on the patient's health status or sex. The direct fee may be paid by the direct patient, by the
150	150	5.23patient's legal representative, or on the patient's behalf by a third party. The direct fee may
151	151	5.24be billed at the end of each monthly period or may be paid in advance for a period not to
152	152	5.25exceed 12 months.
153	153	5.26 (b) If a patient chooses to pay the monthly fee in advance, the funds must be held by the
154	154	5.27direct practice in a trust account with the monthly fee paid to the direct practice as earned
155	155	5.28at the end of each month.
156	156	5.29 (c) Upon receipt of a written notice of termination of the direct agreement from a direct
157	157	5.30patient or the patient's legal representative, the direct practice must promptly refund the
158	158	5.31unearned amount of the direct fees held in trust. If the direct practice discontinues care for
159	159	5.32any reason described under subdivision 3, the direct practice must promptly refund to the
160	160	5.33direct patient the unearned amount of the direct fees held in trust and at a prorated amount
161	161	5Sec. 3.
162	162	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
163	163	6.2was sent to the direct patient or the direct patient's legal representative.
164	164	6.3 (d) A direct practice shall not increase the monthly fee that has been negotiated with an
165	165	6.4existing direct patient more frequently than on an annual basis. A direct practice must
166	166	6.5provide advance notice of at least 60 days to existing patients of any change in the direct
167	167	6.6fee.
168	168	6.7 Subd. 5.Conduct of business.(a) A direct practice must maintain appropriate accounts
169	169	6.8regarding payments made and services received by a direct patient and upon request provide
170	170	6.9any data requested to the direct patient or the patient's legal representative.
171	171	6.10 (b) A direct practice must not submit a claim for payment to a health plan company for
172	172	6.11a primary care service provided to a direct patient that is covered by a direct agreement.
173	173	6.12 (c) No person shall make, publish, or disseminate any false, deceptive, or misleading
174	174	6.13representation or advertising related to the business of a direct practice.
175	175	6.14 (d) No person shall make, issue, or circulate, or cause to be made, issued, or circulated,
176	176	6.15a misrepresentation of the terms of a direct agreement or the benefits or advantages promised,
177	177	6.16or use the name or title of a direct agreement misrepresenting the nature of the direct
178	178	6.17agreement.
179	179	6.18 Subd. 6.Other care not prohibited.A direct primary care practice is not prohibited
180	180	6.19from providing services to other patients under a separate contract with a health plan
181	181	6.20company.
182	182	6.21 Subd. 7.Enforcement.A violation of this section shall constitute unprofessional conduct
183	183	6.22and may be grounds for disciplinary action under chapters 147 and 148.
184	184	6Sec. 3.
185	185	REVISOR SGS/MI 25-0075601/21/25