Colorado § 6-23-101 Definitions

Colorado Statutes

§ 6-23-101 — Definitions

Colorado·Title 06 Consumer·Art. Direct Primary Care

As used in this section:

(1)Direct primary care agreement means a written agreement that:

(a)Is between a patient, his or her legal representative, a government entity, or a patient's employer and a direct primary health-care provider;

(b)Discloses and describes to the patient and to the person paying the direct primary care fee the primary care services to be provided in exchange for payment of a periodic fee;

(c)Specifies the periodic fee required and any additional fees that may be charged;

(d)May allow the periodic fee and any additional fees to be paid by a third party;

(e)Prohibits the provider from submitting a fee-for-service claim for payment to a health insurance issuer for primary care services covered under the agreement and states that some services may be a

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As used in this section:

(1) Direct primary care agreement means a written agreement that:

(a) Is between a patient, his or her legal representative, a government entity,
or a patient's employer and a direct primary health-care provider;

(b) Discloses and describes to the patient and to the person paying the direct
primary care fee the primary care services to be provided in exchange for payment
of a periodic fee;

(c) Specifies the periodic fee required and any additional fees that may be
charged;

(d) May allow the periodic fee and any additional fees to be paid by a third
party;

(e) Prohibits the provider from submitting a fee-for-service claim for
payment to a health insurance issuer for primary care services covered under the
agreement and states that some services may be a covered benefit or covered
service under the patient's health benefit plan as defined in section 10-16-102, at no
cost to the patient;

(f) Conspicuously and prominently discloses to all parties subject to the
agreement that it is not health insurance and does not meet any individual health
benefit plan mandate that may be required by federal law and the patient is not
entitled to health insurance protections for consumers under title 10; and

(g) Allows either party to terminate the agreement, in writing and with
notice, as specified in the agreement and subject to refund terms and conditions in
the agreement.

(2) Direct primary health-care provider means an individual or legal entity
that is licensed under article 240 of title 12 or part 1 of article 255 of title 12 to
provide primary care services in this state and who enters into a direct primary care
agreement. Direct primary health-care provider includes an individual primary
care provider or other legal entity, alone or with others professionally associated
with the individual or other legal entity.

(3) Primary care service includes the screening, assessment, diagnosis, and
treatment for the purpose of promotion of health or the detection and management
of disease or injury within the competency and training of the primary care provider.

Colorado § 6-23-101 (Definitions) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Legislative History

Source: L. 2017: Entire article added, (HB 17-1115), ch. 151, p. 511, � 2, effective August 9. L. 2019: (2) amended, (HB 19-1172), ch. 136, p. 1646, � 16, effective October 1. L. 2020: (2) amended, (HB 20-1183), ch. 157, p. 695, � 31, effective July 1.