Texas became the 13th state to enact Direct Primary Care legislation on May 28, 2015 when House Bill 1945 "An Act Relating to the Provision of Direct Primary Care" was signed by the governor.  The law, now reflected in the Texas Occupations Code Chapter 162 Subchapter F, is generally well written and is helpful for DPC physicians.  It protects physicians from many scenarios beyond the most concerning and obvious potential opponent (the state insurance commissioner).

It is also worth noting that a proposed constitutional amendment favoring "Direct Care," but not specifically mentioning DPC or providing any business of insurance protections, was previously authored in 2013 but died in committee in April of that same year. Be sure to review the Texas Insurance Code when planning your DPC practice, and note that Texas is one of the harshest states when it comes to the prohibition of in-office dispensing of medications (you are essentially limited to a three day supply).  Fortunately the Texas Academy of Family Physicians is supportive of the DPC model.  When starting your DPC practice and deciding on the type of entity you plan to form look to this informational page from the Texas Secretary of State.  

For those seeking additional information about in office dispensing hurdles, please review the text of the Texas Occupations Code, Title 3 Health Professions, Subtitle B Physicians, Chapter 158 Authority of Physician to Provide Certain Drugs and Supplies.  The problem is also discussed on pages 6 & 7 of this review manuscript on dispensing.  Attempts have been made to correct this law, but the pharmacy lobby has repeatedly protected this bad legislation by peddling alleged safety concerns to naive state policy makers.  Physicians are well versed in drug interactions, especially for the small amount (likely 20-40) of medications they would be dispensing regularly.  

Fortunately Michael Garrett, MD (a DPC Physician) and Kris Held, MD (an ophthalmologist) have joined up with the Institute for Justice to make an effective state constitutional law argument against the state boards of both medicine and pharmacy. Here is a copy of the complaint that was filed in June 2019.