”20-HB1867/SB2317 – Smith/Roberts

This bill expands the Health Care Empowerment Act to allow all licensed medical professionals, instead of only physicians, to use direct medical care agreements without regulation by the insurance laws of this state.
In 2016, the legislature enacted the Health Care Empowerment Act, which establishes requirements for direct medical care membership agreements (discussed below) and specifies the following:
(1) A patient or a legal representative of a patient may seek and pay for care outside of an insurance plan or the TennCare or Medicare programs;
(2) A licensed physician, other licensed medical professional, or a health care facility may accept payment for services or medical products outside of an insurance plan or for services or products provided to a TennCare or Medicare beneficiary;
(3) A patient or legal representative does not forfeit insurance benefits, TennCare benefits, or Medicare benefits by purchasing medical services or medical products outside the system; and
(4) The offer and provision of medical services or medical products purchased and provided under the Act is not deemed an offer of insurance nor regulated by the insurance laws of the state.
In a direct medical care agreement under the Act, a physician agrees to provide primary care services to the individual patient for an agreed fee over an agreed period of time; the direct primary care physician does not bill third parties on a fee-for-service basis; any per-visit charges under the agreement are less than the monthly equivalent of the periodic fee.
This bill revises the Act to allow all direct medical providers to enter into "direct medical care agreements."
This bill defines "direct medical care provider," as an individual or legal entity that is licensed, registered, or otherwise authorized to provide medical care services in this state and who chooses to enter into a direct medical care agreement. The term includes an individual medical care provider or other legal entity, alone or with others professionally associated with the provider or other legal entity.