71-9503. Terms, defined.

For purposes of the Direct Primary Care Agreement Act:

(1) Direct agreement means a direct primary care agreement entered into on or after July 21, 2016, meeting the requirements of section 71-9504;

(2) Direct patient means an individual or family that is party to a direct agreement and is entitled to receive primary care services under the direct agreement from the direct provider;

(3) Direct provider means (a) a physician or nurse practitioner who is licensed under the Uniform Credentialing Act, who specializes or is board-certified in general practice, family medicine, internal medicine, or pediatrics, and who provides primary care services through a direct agreement, (b) a group of physicians or nurse practitioners who are licensed under the Uniform Credentialing Act, who specialize or are board-certified in general practice, family medicine, internal medicine, or pediatrics, and who provide primary care services as a group through a direct agreement, or (c) an entity that sponsors, employs, or is otherwise affiliated with a group of physicians or nurse practitioners, which physicians or nurse practitioners are licensed under the Uniform Credentialing Act, specialize or are board-certified in general practice, family medicine, internal medicine, or pediatrics, and provide only primary care services as a group through a direct agreement if (i) the entity is wholly owned by the group of physicians or nurse practitioners or is a nonprofit corporation exempt from taxation under section 501(c)(3) of the Internal Revenue Code of 1986 and (ii) the entity is not otherwise regulated as a health care service contractor, health maintenance organization, or disability insurer. Such an entity is not prohibited from sponsoring, employing, or being otherwise affiliated with other types of health care providers not engaged in a direct agreement;

(4) Direct service charge means a charge for primary care services provided by, or to be provided by, the direct provider to the direct patient. Direct service charge includes a charge in any form, including a periodic retainer, membership fee, subscription fee, or other charge paid under a direct agreement;

(5) Patient’s representative means a guardian or other person holding a power of attorney for health care; and

(6) Primary care means general health care services of the type provided at the time a patient seeks preventive care or first seeks health care services for a specific health concern. Primary care may include, but not be limited to:

(a) Care which promotes and maintains mental and physical health and wellness;

(b) Care which prevents 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.

Source

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