Bill > LD1511

This bill expands the existing Maine law on direct primary care service agreements by changing terminology from "direct primary care" to "direct health care," which broadens the scope of healthcare services that can be covered under these agreements. The bill modifies definitions to allow more types of healthcare providers, including allopathic and osteopathic physicians and other advanced healthcare practitioners, to enter into direct health care service agreements. These agreements are explicitly defined as contracts between a healthcare provider and a patient where the provider agrees to offer specific health services for a set fee over a specified time period, without billing third parties for those services. The bill emphasizes that these agreements are not insurance policies and are not subject to insurance regulation. Key provisions include requirements for clear disclosure to patients that these agreements are not health insurance, do not meet federal health insurance mandates, and may not be reimbursed by insurance policies. The legislation also prevents insurance carriers from denying payment for healthcare services referred by direct health care providers who are not in the carrier's network and ensures that patients are not penalized with higher deductibles or copayments when using such providers. Overall, the bill aims to provide more flexibility and options for healthcare service arrangements outside traditional insurance frameworks.

Health and Social Services

https://legislature.maine.gov/legis/bills/display_ps.asp?LD=1511&snum=132