SB735 - Health insurance; denial of referral by direct primary care provider prohibited.

1 Co-Sponsor

Health insurance; denial of referral by direct primary care provider prohibited. Prohibits a health insurance carrier from (i) denying payment for any health care service covered under an enrollee's health benefit plan based solely on the basis that such enrollee's referral was made by a direct primary care provider or (ii) imposing a cost-sharing requirement greater than the applicable cost-sharing requirement that would apply to the same health care service if the service was referred by a participating provider. The bill provides that a health insurance carrier may require a direct primary care provider to provide information demonstrating that such provider has entered into a direct primary care agreement with the enrollee.