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Senate bill would protect DPC providers from insurance regulations

A proposed committee substitute before the Senate Health Committee would protect direct primary care (DPC) providers from having to comply with state health insurance regulations. DPC providers are primary care doctors who do not accept insurance for payment. Instead, they charge each patient a monthly membership for around the clock access to the primary care doctors. The average monthly membership fee is $82, and 82 percent of family memberships cost between $50 and $225. The DPC practice has grown in popularity in recent years as physicians become tired of spending more time on insurance paperwork than they do with patients. Removing the third-party payer model from the purchasing of health care allows the patient more affordable access and can produce better health outcomes because the physician can spend more time with patients.

DPC practices are currently exempt from health insurance regulations. The department of Insurance has not viewed the payment between a patient and DPC provider as an insurance agreement, such as other arrangements where an individual would pay a premium to an insurance company. However, DPC doctors still have to be licensed by the North Carolina Medical Board. Today, the Senate Health Committee discussed a bill that would codify these protections into law. The bill states specifically that DPC arrangements are not insurance and, therefore, not subject to insurance regulations.

Protecting DPC doctors from insurance regulations is essential to the cost-effective model used by these professionals. It will be even more essential that if this bill is passed, legislators don’t try to come back after the fact and impose additional regulations on DPC providers.

For more information on DPC, see:

Jordan Roberts / Health Policy Analyst

Jordan joined the Locke Foundation in the summer of 2018 as Health Care Policy Analyst. He analyzes state and national health policy issues with an eye toward removing governm...

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