An Act relative to patient access to primary care services

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Bill H.1120

SECTION 1. The Massachusetts General Laws, as appearing in the 2022 Official Edition, is hereby amended by inserting after chapter 176X, the following chapter:-

CHAPTER 176Y.

Consumer choice of direct primary care.

Section 1. Definitions

As used in this chapter the following words shall, unless the context clearly requires otherwise, have the following meanings:

"Direct primary care provider", an individual or legal entity that is licensed, registered or otherwise authorized to provide primary care services in this state and who chooses to enter into a direct primary care membership agreement. This includes, but is not limited to, an individual primary care provider or other legal entity alone or with others professionally associated with the individual or other legal entity.

"Direct primary care membership agreement", a contractual agreement between a primary care provider and an individual patient, or his or her legal representative, in which:

i. The provider agrees to provide primary care services to the individual patient for an agreed-to fee over an agreed-to period of time;

ii. The direct primary care provider will not bill third parties on a fee-for-service basis; and

iii. Any per-visit charges under the agreement will be less than the monthly equivalent of the periodic fee.

Section 2. A direct primary care membership agreement shall include the following:

i. Is between a patient or their legal representative and a health care provider;

ii. Allows either party to terminate the agreement in writing, without penalty or payment of a termination fee, at any time or after notice as specified in the agreement which notice shall not exceed sixty (60) days;

iii. Describes the health care services to be provided in exchange for payment of a periodic fee;

iv. Specifies the periodic fee required and any additional fees that may be charged;

v. May allow the periodic fee and any additional fees to be paid by a third party;

vi. Prohibits the provider from charging or receiving additional compensation for health care services included in the periodic fee; and

vii. Conspicuously and prominently states that the agreement is not health insurance and does not meet any individual health insurance mandate that may be required by federal law.

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