Bill > SB4

This bill establishes a legal framework for direct primary care (DPC) agreements, which are alternative healthcare service contracts where patients pay a fixed subscription fee to a healthcare provider for primary care services, instead of using traditional fee-for-service or insurance-based models. The bill exempts these agreements from standard insurance regulations and defines specific requirements for a valid DPC agreement, including that it must be in writing, signed by both parties, allow termination by either party, describe specific services, specify fees and duration, and explicitly state that the agreement is not health insurance. The bill protects patients by preventing providers from declining agreements based on health status, with providers only able to refuse patients if their practice is at capacity or they cannot provide appropriate care. Providers can terminate agreements under limited circumstances such as non-payment, patient fraud, repeated treatment plan non-adherence, or a breakdown in the provider-patient relationship. Importantly, the bill requires clear disclosures that these agreements do not replace comprehensive health insurance and may not satisfy federal insurance coverage requirements, and encourages patients to consult with insurance advisors before entering such agreements.

Health and Social Services

https://docs.legis.wisconsin.gov/2025/proposals/reg/sen/bill/sb4