329:1-e Direct Primary Care. –
I. In this section:
(a) "Direct primary care agreement" means a written agreement between a primary care provider and a patient, a patient's legal representative, or a patient's employer, which meets the requirements of paragraph II.
(b) "Primary care provider" means a health care provider licensed under RSA 329, RSA 326-B, or RSA 328-D, or a primary care group practice, who provides primary care services to patients.
(c) "Primary care services" mean medical services in family practice, general practice, internal medicine, pediatrics, obstetrics, or gynecology including the screening, assessment, diagnosis, and treatment of a patient conducted within the competency and training of the primary care provider for the purpose of promoting health or detecting and managing disease or injury.
II. Primary care services resulting from a primary care provider entering a direct primary care agreement is not insurance and the primary care provider shall not be subject to the requirements of RSA 415, RSA 420, or the jurisdiction of the commissioner when the following conditions are met:
(a) The agreement is in writing and signed by the primary care provider, or agent, and the individual patient or his or her legal representative.
(b) The agreement specifies the periodic fee required and any additional fees for services not covered by the periodic fee, and may allow the periodic fee and any additional fees to be paid by a third party.
(c) The agreement describes the health care services that are covered by the periodic fee.
(d) The agreement describes the duration of the agreement and any automatic renewal periods.
(e) The agreement 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 shall not exceed 90 days.
(f) The agreement prominently states that the agreement is not health insurance and the primary care provider will not file any claims against the patient's health insurance policy or plan for reimbursement of any primary care services covered by the agreement.
(g) The agreement prominently states that the agreement is not workers' compensation insurance and does not replace an employer's obligations under RSA 281-A.
III. The direct primary care practice shall not decline to accept new direct primary care patients solely because of the patient's health status. A direct primary care practice may decline to accept a patient for cause, including, but not limited to:
(a) The practice has reached a maximum capacity;
(b) The patient has previously contracted for services for which they have not paid; or
(c) The patient's medical condition is such that the provider is unable to provide the appropriate type of primary care services.
IV. If the direct primary care practice provides the patient with notice and opportunity to obtain care from another physician, the direct primary care practice may discontinue care for a patient for cause, including, but not limited to:
(a) The patient fails to pay the periodic fee.
(b) The patient has performed an act of fraud.
(c) The patient repeatedly fails to adhere to the recommended treatment plan.
(d) The patient is abusive and presents an emotional or physical danger to the staff or other patients of the direct practice.
(e) The primary care provider discontinues operation as a direct primary care practice.
V. A direct primary care agreement may authorize a primary care provider to serve as a patient's authorized representative and as a claimant's representative as defined in RSA 420-J:3 and participate in grievance procedures under RSA 420-J:5 and request external review under RSA 420-J:5-a, 420-J:5-b, and 420-J:5-c.