By Julie Havlak
Carolina Journal News Service
RALEIGH — A Senate committee passed protection for direct primary care providers and discussed regulatory reforms to prepare hospitals and other health care workers for the second wave of the coronavirus.
The Senate Health Care Committee on Thursday, May 28, unanimously passed House Bill 471 to help direct primary care doctors — doctors who take monthly cash payments rather than bill insurance companies. DPC doctors say they often treat uninsured and underinsured patients who can’t otherwise afford preventive care. They can offer affordable prices because they don’t face the overhead costs of insurance and regulations.
H.B. 471 would shield the DPC business model by clarifying that direct primary care isn’t insurance. DPC doctors aren’t regulated by the Department of Insurance. The bill would codify their current status.
“It ensures that DPC providers can continue their business model of contracting directly with patients,” said Jordan Roberts, John Locke Foundation health care policy analyst. “They’re charging so little to provide care. If they were subject to these regulations, it’d be disastrous to their low-cost model.”
The bill heads to the Senate Rules Committee.
Next week, the committee will continue to debate and likely vote on House Bill 678. It reforms occupational licensing, scope of practice, and health care supply controls known as Certificate of Need laws. The goal is to give the health care system flexibility to handle a second surge in coronavirus cases. Lawmakers began a debate on Thursday that could redefine the price and availability of health care across the state.
H.B. 678 would waive CON laws for care related to COVID-19, allow out-of-state health care providers to care for patients, and help protect patients in nursing homes and congregate living settings for the duration of the pandemic. Reforms would last one year after the state of emergency ends.
Gov. Roy Cooper’s COVID-19 executive orders waived those rules temporarily.
“We’re here in this economic crisis for one reason: Our health care professionals and statisticians didn’t have the confidence our system had the resources to handle the surge,” said Sen. Chuck Edwards, R-Henderson. “We can allow our health care professionals to look ahead, plan ahead, and determine what they feel they need to prepare for the next wave.”
Senators say the bill is needed to create the flexibility current executive orders lack. Cooper’s reforms last only as long as the state of emergency. Lawmakers want to give health care providers the certainty of a year-long waiver.
“The state of emergency is an on-off switch,” Sen. Ralph Hise, R-Mitchell, said. “You’re either under it, or you’re not.”
The bill could help mitigate the uncertainty surrounding the expected second wave of coronavirus cases, said Roberts.
“There’s so much uncertainty in the future,” Roberts said. “We don’t know the extent of the second wave, and leaving these decisions to the people on the ground who are caring for patients is the right decision.”
Lawmakers said they were sick of waiting to take action.
“We’re going to debate until the end of time what should have taken place during this pandemic,” Edwards said. “At every given turn, it seems we’ve been reactive, not proactive. We’ve always been a few steps behind.”
