Why Do We Need to Define Direct Primary Care?
Defining DPC in no way restricts your freedom to contract with a patient in any way you like. You could intentionally change the contract to NOT be defined as DPC if this suits your interests more. Definitions are needed when there is a gray area in the law - you either get there via legislation - legislation that we can help author and shape - or via a judicial decision - an area of uncertainty that most physicians fear.
A definition of DPC in each state = lower legal barriers to entry = less uncertainty = wider adoption of DPC.
This definition does NOT:
1) exclude hybrid practices - a physician may have some patients that are DPC, and others that are not.
2) mean that other non-DPC relationships are in any way illegal. If a practice fails to meet this definition it simply means that it was not the type of practice that would have received negative attention from the insurance commissioner in the first place - and thus it did not need to be defined in this protected class.
3) prohibit ancillary fees - labs, radiology, procedures are permissible as add-on ancillary fees. The per visit fee referenced in the definition is a simple flat fee that is imposed on any in-person interaction between the patient and the physician. When the per visit fee is higher than the monthly fee, the practice begins to function more like a cash pay urgent care, and no longer has unwanted attention from the insurance commissioner.