North Carolina has a large number of DPC practices compared to most states, largely due to Brian Forrest, MD of Access Healthcare, who has formed a network across the state (and outside of the state). Dr. Forrest and the Consortium for Southeastern Hypertension Control have received a Transforming Clinical Practices Initiative's Grant in the amount of $15.8 Million as discussed in this press release. No DPC laws are in place, and none are planned this legislative session. The insurance commissioner has historically taken a "watchful waiting" approach. If you plan to open a DPC practice in North Carolina, be sure to begin by reviewing North Carolina General Statutes Chapter 58 - Insurance, note that while North Carolina has historically made it difficult to conduct in-office dispensing, a review of their updated rules demonstrates few restrictions, but you will need to register as a dispensing physician and a review of the NC Board of Pharmacy's FAQs will also be helpful.
The following portions of the North Carolina General Statutes might be especially useful to DPC physicians:
§ 58-1-10. Contract of insurance.
A contract of insurance is an agreement by which the insurer is bound to pay money or its equivalent or to do some act of value to the insured upon, and as an indemnity or reimbursement for the destruction, loss, or injury of something in which the other party has an interest.
(d) "Health care plan" means any arrangement whereby any person undertakes on a prepaid basis to provide, arrange for, pay for, or reimburse any part of the cost of any health care services and at least part of such arrangement consists of arranging for or the provision of health care services, as distinguished from mere indemnification against the cost of such services on a prepaid basis through insurance or otherwise.
(e) "Health care services" means any services included in the furnishing to any individual of medical or dental care, or hospitalization or incident to the furnishing of such care or hospitalization, as well as the furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing, or healing human illness or injury.
(f) "Health maintenance organization" or "HMO" means any person who undertakes to provide or arrange for the delivery of health care services to enrollees on a prepaid basis except for enrollee responsibility for copayments and deductibles. For the purposes of 11 U.S.C. § 109(b) (2) and (d), an HMO is a domestic insurance company.