Bill allowing direct primary care agreements moves ahead in Legislature

By Martha Stoddard
World-Herald Bureau, 

LINCOLN — Lawmakers advanced a bill Tuesday that would open the door for doctors and patients in Nebraska to adopt an alternative to health insurance.

Legislative Bill 817, introduced by State Sen. Merv Riepe of Omaha, would allow what are called “direct primary care agreements.”

The bill cleared the first of three rounds of consideration on a 38-0 vote.

Under the agreements, patients pay a flat monthly fee to their family doctor or nurse practitioner, typically $40 to $100.

In return, they get all their primary care needs met without having to file insurance paperwork, meet deductibles or worry about co-payments.

Sen. Mark Kolterman of Seward, who has his own insurance agency, said the bill would make health care more affordable for some families.

“This bill is about additional choices for our consumers,” he said.

Riepe said direct primary care agreements are a free-market option.

Providers like them because they eliminate the cost and stress of dealing with health insurance, he said. Typically, the deals reduce the number of patients providers see, which allows them to get to know patients better and have a healthier work-life balance.

Patients, too, like providers to more time with them and to work through complicated medical conditions, Riepe said.

The style of care focuses on preventing health problems and monitoring chronic conditions to avoid hospitalizations and emergency room visits.

The agreements can be paired with wrap-around health insurance plans, which can cover the cost of specialists and hospitals.

LB 817 would set basic standards for direct primary care agreements, including requirements that the deals describe the limits of what the monthly payments cover and spell out all charges.

The bill also would make clear that the agreements are not insurance and therefore not subject to state insurance regulations.

In addition, LB 817 would allow providers to see a mix of patients, including some with the agreements and some with traditional health insurance, Medicare or Medicaid.

Sen. Kathy Campbell of Lincoln, chairwoman of the Health and Human Services Committee, said the agreements could work well for a segment of Nebraskans.

However, they cannot now be used by people covered by Medicare or Medicaid.

Individual employers would have to decide whether to offer direct primary care agreements as an option for their workers.

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