FINAL BILL REPORT

ESHB 1480

C 126 L 13

Synopsis as Enacted

Brief Description: Concerning the provision of prescription drugs by direct practice providers.

Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Green, Schmick, Cody, Harris and Jinkins).

House Committee on Health Care & Wellness

Senate Committee on Health Care

Background:

A direct practice is a provider, group of providers, or entity that:

• charges a fee (known as the "direct fee") for primary care services;

• provides only primary care;

• describes the services it provides and fees that it charges in written agreements with patients; and

• does not bill insurance.

Direct practices are not considered insurance and are therefore exempt from most insurance laws.

A direct practice may not provide prescription drugs in consideration for the direct fee. However, a direct practice may charge an additional fee for medications that are specifically excluded under the patient's agreement with the practice; the direct practice must notify the patient of the additional charge prior to delivery of the medications.

A direct practice may pay for charges associated with lab and imaging services. Payments for lab and imaging services may not exceed 15 percent of the direct fee charged to the patient, except in cases of short-term equipment failure.

Summary:

A direct practice may pay for charges associated with the dispensing, at no additional cost to the direct patient, of an initial supply of generic prescription drugs prescribed by the direct provider. The initial supply may not exceed 30 days. In aggregate, payments for prescription drugs and lab and imaging services may not exceed 15 percent of the direct fee charged to the patient.

Votes on Final Passage: