Bill > HB3015

This bill introduces a new provision for state health benefit plans in Texas that allows direct primary care (DPC) fees to be applied to insurance deductibles. The bill defines a "direct fee" broadly to include various payment structures like monthly retainers, membership fees, subscription fees, and fees for specific medical services provided by a physician. These fees can now be counted towards an individual's insurance deductible for three specific state health benefit programs: the group benefits program, the group program, and health coverage plans. The bill includes an important caveat that if applying these direct primary care fees might disqualify a high-deductible health plan from being eligible for a health savings account (HSA), the board of trustees must seek an attorney general's opinion, and if confirmed, the provision would not apply to that specific plan. The new law will apply to plan years beginning on or after January 1, 2026, and will take effect on September 1, 2025. This legislation aims to provide more flexibility in how primary care services are paid for and recognized within state health benefit plans, potentially making direct primary care arrangements more financially attractive for participants.

Budget and Finance, Labor and Employment

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB3015