HB541 - Relating to the provision of direct patient care by physicians and health care practitioners.

      H.B. No. 541         AN ACT   relating to the provision of direct patient care by physicians and   health care practitioners.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter F, Chapter 162, Occupations Code, is   transferred to Subtitle A, Title 3, Occupations Code, redesignated   as Chapter 117, Occupations Code, and amended to read as follows:   CHAPTER 117 [ SUBCHAPTER F ]. DIRECT PATIENT [ PRIMARY ] CARE          Sec.  117.001  [ 162.251 ].  DEFINITIONS. In this chapter   [ subchapter ]:                (1)  "Direct fee" means a fee charged by a physician or   health care practitioner to a patient or a patient's designee for   health [ primary medical ] care services provided by, or to be   provided by, the physician or practitioner to the patient. The term   includes a fee in any form, including a:                      (A)  monthly retainer;                      (B)  membership fee;                      (C)  subscription fee;                      (D)  fee paid under a direct patient care [ medical   service ] agreement; or                      (E)  fee for a service, visit, or episode of care.                (2)  "Direct patient [ primary ] care" means a health   [ primary medical ] care service provided by a physician or health   care practitioner to a patient in return for payment in accordance   with a direct fee. The term includes telemedicine medical services   and telehealth services, as those terms are defined by Section   111.001, provided using a technology platform.                (3)   "Direct patient care agreement" means a signed   written agreement under which a physician or health care   practitioner agrees to provide health care services to a patient in   exchange for a direct fee for a period of time that is entered into   by the physician or practitioner and:                       (A)  the patient;                       (B)     the patient's legal representative,   guardian, or employer on behalf of the patient; or                       (C)     the patient's legal representative's or   guardian's employer on behalf of the patient.                 (4)     "Health care practitioner" means an individual who   holds a license, certificate, permit, or other authorization issued   under this title to engage in a health care profession and who   provides health care in the ordinary course of business or practice   of a profession. The term does not include a physician.                 (5)     "Health care service" means any care, service, or   procedure provided by a physician or health care practitioner. The   term includes any medical or psychological diagnosis, treatment,   evaluation, advice, or other service that affects the structure or   function of the human body [ "Medical service agreement" means a   signed written agreement under which a physician agrees to provide   direct primary care services for a patient in exchange for a direct   fee for a period of time that is entered into by the physician and:                      [ (A)  the patient;                      [ (B)     the patient's legal representative,   guardian, or employer on behalf of the patient; or                      [ (C)     the patient's legal representative's or   guardian's employer on behalf of the patient ].                 (6)  [ (4) ]  "Physician" means a person licensed to   practice medicine in this state. The term includes a professional   association or professional limited liability company owned   entirely by an individual licensed under Subtitle B [ this   subtitle ].                [ (5)     "Primary medical care service" means a routine or   general health care service of the type provided at the time a   patient seeks preventive care or first seeks health care services   for a specific health concern, is a patient's main source for   regular health care services, and includes:                      [ (A)     promoting and maintaining mental and   physical health and wellness;                      [ (B)  preventing disease;                      [ (C)     screening, diagnosing, and treating acute   or chronic conditions caused by disease, injury, or illness;                      [ (D)     providing patient counseling and education;   and                      [ (E)     providing a broad spectrum of preventive and   curative health care over a period of time. ]          Sec.  117.002  [ 162.252 ].  APPLICABILITY OF CHAPTER   [ SUBCHAPTER ]. This chapter [ subchapter ] does not apply to workers'   compensation insurance coverage as defined by Section 401.011,   Labor Code.          Sec.  117.003  [ 162.253 ].  DIRECT PATIENT [ PRIMARY ] CARE NOT   INSURANCE. (a) A physician or health care practitioner providing   direct patient [ primary ] care is not an insurer or health   maintenance organization, and the physician or practitioner is not   subject to regulation by the Texas Department of Insurance for the   direct patient [ primary ] care.          (b)  A direct patient care [ medical service ] agreement is not   health or accident insurance or coverage under Title 8, Insurance   Code, and is not subject to regulation by the Texas Department of   Insurance.          (c)  A physician or health care practitioner is not required   to obtain a certificate of authority under the Insurance Code to   market, sell, or offer a direct patient care [ medical service ]   agreement or provide direct patient [ primary ] care.          (d)  A physician or health care practitioner providing   direct patient [ primary ] care does not violate Section 1204.055,   Insurance Code.          Sec.  117.004  [ 162.254 ].  BILLING INSURER OR HEALTH   MAINTENANCE ORGANIZATION PROHIBITED. A physician or health care   practitioner may not bill an insurer or health maintenance   organization for direct patient [ primary ] care that is paid under a   direct patient care [ medical service ] agreement.          Sec.  117.005  [ 162.255 ].  INTERFERENCE PROHIBITED. (a) The   Texas Medical Board [ board ] or another state agency may not   prohibit, interfere with, initiate a legal or administrative   proceeding against, or impose a fine or penalty against:                (1)  a physician or health care practitioner solely   because the physician or practitioner provides direct patient   [ primary ] care; or                (2)  a person solely because the person pays a direct   fee for direct patient [ primary ] care.          (b)  A health insurer, health maintenance organization, or   health care provider as that term is defined by Section 105.001   may  not prohibit, interfere with, or initiate a legal proceeding   against:                (1)  a physician or health care practitioner solely   because the physician or practitioner provides direct patient   [ primary ] care; or                (2)  a person solely because the person pays a direct   fee for direct patient [ primary ] care.          Sec.  117.006  [ 162.256 ].  REQUIRED DISCLOSURE. A physician   or health care practitioner providing direct patient [ primary ] care   shall provide written or electronic notice to the patient that a   direct patient care [ medical service ] agreement for direct patient   [ primary ] care is not insurance, prior to entering into the   agreement.          SECTION 2.  The changes in law made by this Act apply only to   an agreement entered into on or after the effective date of this   Act. An agreement entered into before the effective date of this   Act is governed by the law applicable to the agreement immediately   before the effective date of this Act, and that law is continued in   effect for that purpose.          SECTION 3.  This Act takes effect immediately if it receives   a vote of two-thirds of all the members elected to each house, as   provided by Section 39, Article III, Texas Constitution.  If this   Act does not receive the vote necessary for immediate effect, this   Act takes effect September 1, 2025.       ______________________________ ______________________________      President of the Senate Speaker of the House                   I certify that H.B. No. 541 was passed by the House on May 8,   2025, by the following vote:  Yeas 144, Nays 1, 2 present, not   voting.     ______________________________   Chief Clerk of the House                 I certify that H.B. No. 541 was passed by the Senate on May   28, 2025, by the following vote:  Yeas 31, Nays 0.     ______________________________   Secretary of the Senate       APPROVED:  _____________________                      Date                           _____________________                    Governor