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New DOI Guidance on Direct Primary Care Practices in Massachusetts

Thursday, April 28, 2016 12:00 PM to 1:30 PM
Boston Bar Association - 16 Beacon Street, Boston, MA


The Massachusetts Division of Insurance (DOI) has issued informal responses on how physicians who are interested in establishing direct primary care practices can establish and operate without triggering the need to be regulated as engaging in the provision of insurance. This program will be presented by two health lawyers who represent such physicians and helped secure such guidance from the DOI.   
Currently, as primary care physicians in Massachusetts are seeking alternative ways to maintain their independence, provide innovative patient focused quality care and remain financially viable, many new models of care have emerged such as concierge practices and medical homes. Direct primary care is a new model in which the physician withdraws from all payers and charges patients a flat fee for a scope of services. Such a model has raised many regulatory issues, particularly as to whether this model needs to be regulated as the business of insurance. Many states have passed legislation clearing the path for DPC practices, but, to date, Massachusetts has no such law.

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Cassandra Shavney


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