2019 Tennessee Code
Title 63 - Professions of the Healing Arts
Chapter 1 - Division of Health Related Boards
Part 5 - Health Care Empowerment Act
§ 63-1-502. Part definitions.
- As used in this part:
(1) “Direct primary care agreement” means a written contractual agreement between a direct primary care physician and an individual patient, or the patient's legal representative, in which:
(A) The direct primary care physician agrees to provide primary care services to the individual patient for an agreed fee over an agreed period of time;
(B) The direct primary care physician will not bill third parties on a fee-for-service basis;
(C) Any per-visit charges under the agreement will be less than the monthly equivalent of the periodic fee;
(D) The agreement describes the scope of primary service that is covered by the periodic fee;
(E) The agreement contains the following disclosures, or substantially similar disclosures, that are conspicuously visible in the agreement in bold font:
(i) The agreement does not constitute health insurance under the laws of this state;
(ii) An uninsured patient that enters into a direct primary care agreement may still be subject to tax penalties under the Patient Protection and Affordable Care Act, Public Law 111-148, for failing to obtain insurance;
(iii) Patients insured by health insurance plans that are compliant with the Patient Protection and Affordable Care Act already have coverage for certain preventative care benefits at no cost to the patient;
(iv) Payments made by a patient for services rendered under a direct primary care agreement may not count towards the patient's health insurance deductibles and maximum out-of-pocket expenses;
(v) A patient is encouraged to consult with the patient's health insurance plan, before entering into the agreement and receiving care; and
(vi) A direct primary care physician who breaches the agreement may be liable for damages and may be subject to discipline by the appropriate licensing board;
(F) The agreement specifies the duration of the agreement, including automatic renewal periods; and
(G) The patient is not required to pay more than twelve (12) months of the fee in advance; provided, that the contracted fee may be paid on a payment schedule agreed to by direct primary care physician and patient that may be due on a monthly, quarterly, or yearly basis;
(2) “Direct primary care physician” means an individual or legal entity that is licensed, registered, or otherwise authorized to provide primary care services in this state under this title, and who chooses to enter into a direct primary care agreement. A direct primary care physician includes an individual primary care physician or other legal entity, alone or with others professionally associated with the physician or other legal entity;
(3) “Medical products” include medical drugs and pharmaceuticals;
(4) “Primary care physician” or “physician” means a physician licensed under chapters 4, 6, or 9 of this title; and
(5) “Primary care service” includes the screening, assessment, diagnosis, and treatment for the purpose of promotion of health or the detection and management of disease or injury within the competency and training of the direct primary care physician or, if applicable, within the scope of practice of a chiropractic physician.
