1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Direct health care service agreement" means a contractual agreement between a direct health care provider and an individual patient, or the patient's legal representative, in which: (1) The direct health care provider agrees to provide health care services to the individual patient for an agreed-to fee over an agreed-to period of time; and (2) The direct health care provider agrees not to bill 3rd parties on a fee-for-service or capitated basis for services already covered in the direct health care service agreement. [PL 2025, c. 358, §2 (AMD).] B. "Direct health care provider" means an individual who is a licensed allopathic physician or osteopathic physician or other advanced health care practitioner who is authorized to engage in independent medical practice in this State and who chooses to practice direct health care by entering into a direct health care service agreement with patients. The term includes, but is not limited to, an individual health care provider or a group of health care providers. [PL 2025, c. 358, §2 (AMD).] C. [PL 2025, c. 358, §2 (RP).] D. "Health care" has the same meaning as in section 1711-C, subsection 1, paragraph C. [PL 2025, c. 358, §2 (NEW).] [PL 2025, c. 358, §2 (AMD).] 2. Not insurance. A direct health care service agreement is not an insurance policy and is not subject to regulation by the Department of Professional and Financial Regulation, Bureau of Insurance. [PL 2025, c. 358, §2 (AMD).] 3. Ability to contract. A direct health care service agreement is an agreement between the direct health care provider and either an individual or the individual's representative, regardless of whether the periodic fee or other fees are paid by the individual, the individual's representative or a 3rd party. [PL 2025, c. 358, §2 (AMD).] 4. Covered services. A direct health care service agreement covers only the services specified in the agreement. Any goods or services that are not covered by the direct health care service agreement may be billed separately. [PL 2025, c. 358, §2 (AMD).] 5. Disclosure. A direct health care service agreement must clearly state within the agreement that direct health care services are not considered health insurance and do not meet requirements of any federal law mandating individuals to purchase health insurance and that the fees charged in the agreement may not be reimbursed or apply towards a deductible under a health insurance policy with an insurer. [PL 2025, c. 358, §2 (AMD).] 6. Other care not prohibited. A health care provider is considered a direct health care provider only when the provider is engaged in a direct health care service agreement with a patient or group of patients. A health care provider is not prohibited from providing care to other patients under a separate agreement or contract with an insurer. [PL 2025, c. 358, §2 (AMD).] 7. Other agreements not prohibited. This section does not prohibit a direct health care provider from entering into: A. An agreement with an insurer offering a policy specifically designed to supplement a direct health care service agreement; or [PL 2025, c. 358, §2 (AMD).] B. A pilot program for direct primary care or direct health care with a federal or state agency that provides health coverage. [PL 2025, c. 358, §2 (AMD).] [PL 2025, c. 358, §2 (AMD).]
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