Bill > HB2315

This bill amends the Health Maintenance Organization Act to require health maintenance organizations (HMOs) to cover services referred by direct primary care providers, even if those providers are not part of the HMO's network, provided the services are otherwise covered by the enrollee's contract. A "direct primary care provider" is defined as a licensed physician or other authorized healthcare practitioner who enters into a direct agreement with a patient for health services and can be an individual or a group. This change aims to ensure enrollees can receive necessary care regardless of their primary care provider's network status.