Relating to the provision of direct patient care by physicians and health care practitioners, the official text

H.B. No. 541

AN ACT

relating to the provision of direct patient care by physicians and

health care practitioners.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter F, Chapter 162, Occupations Code, is

transferred to Subtitle A, Title 3, Occupations Code, redesignated

as Chapter 117, Occupations Code, and amended to read as follows:

CHAPTER 117 [SUBCHAPTER F]. DIRECT PATIENT [PRIMARY] CARE

Sec. 117.001 [162.251]. DEFINITIONS. In this chapter

[subchapter]:

(1) "Direct fee" means a fee charged by a physician or

health care practitioner to a patient or a patient's designee for

health [primary medical] care services provided by, or to be

provided by, the physician or practitioner to the patient. The term

includes a fee in any form, including a:

(A) monthly retainer;

(B) membership fee;

(C) subscription fee;

(D) fee paid under a direct patient care [medical

service] agreement; or

(E) fee for a service, visit, or episode of care.

(2) "Direct patient [primary] care" means a health

[primary medical] care service provided by a physician or health

care practitioner to a patient in return for payment in accordance

with a direct fee. The term includes telemedicine medical services

and telehealth services, as those terms are defined by Section

111.001, provided using a technology platform.

(3) "Direct patient care agreement" means a signed

written agreement under which a physician or health care

practitioner agrees to provide health care services to a patient in

exchange for a direct fee for a period of time that is entered into

by the physician or practitioner and:

(A) the patient;

(B) the patient's legal representative,

guardian, or employer on behalf of the patient; or

(C) the patient's legal representative's or

guardian's employer on behalf of the patient.

(4) "Health care practitioner" means an individual who

holds a license, certificate, permit, or other authorization issued

under this title to engage in a health care profession and who

provides health care in the ordinary course of business or practice

of a profession. The term does not include a physician.

(5) "Health care service" means any care, service, or

procedure provided by a physician or health care practitioner. The

term includes any medical or psychological diagnosis, treatment,

evaluation, advice, or other service that affects the structure or

function of the human body ["Medical service agreement" means a

signed written agreement under which a physician agrees to provide

direct primary care services for a patient in exchange for a direct

fee for a period of time that is entered into by the physician and:

[(A) the patient;

[(B) the patient's legal representative,

guardian, or employer on behalf of the patient; or

[(C) the patient's legal representative's or

guardian's employer on behalf of the patient].

(6) [(4)] "Physician" means a person licensed to

practice medicine in this state. The term includes a professional

association or professional limited liability company owned

entirely by an individual licensed under Subtitle B [this

subtitle].

[(5) "Primary medical care service" means a routine or

general health care service of the type provided at the time a

patient seeks preventive care or first seeks health care services

for a specific health concern, is a patient's main source for

regular health care services, and includes:

[(A) promoting and maintaining mental and

physical health and wellness;

[(B) preventing disease;

[(C) screening, diagnosing, and treating acute

or chronic conditions caused by disease, injury, or illness;

[(D) providing patient counseling and education;

and

[(E) providing a broad spectrum of preventive and

curative health care over a period of time.]

Sec. 117.002 [162.252]. APPLICABILITY OF CHAPTER

[SUBCHAPTER]. This chapter [subchapter] does not apply to workers'

compensation insurance coverage as defined by Section 401.011,

Labor Code.

Sec. 117.003 [162.253]. DIRECT PATIENT [PRIMARY] CARE NOT

INSURANCE. (a) A physician or health care practitioner providing

direct patient [primary] care is not an insurer or health

maintenance organization, and the physician or practitioner is not

subject to regulation by the Texas Department of Insurance for the

direct patient [primary] care.

(b) A direct patient care [medical service] agreement is not

health or accident insurance or coverage under Title 8, Insurance

Code, and is not subject to regulation by the Texas Department of

Insurance.

(c) A physician or health care practitioner is not required

to obtain a certificate of authority under the Insurance Code to

market, sell, or offer a direct patient care [medical service]

agreement or provide direct patient [primary] care.

(d) A physician or health care practitioner providing

direct patient [primary] care does not violate Section 1204.055,

Insurance Code.

Sec. 117.004 [162.254]. BILLING INSURER OR HEALTH

MAINTENANCE ORGANIZATION PROHIBITED. A physician or health care

practitioner may not bill an insurer or health maintenance

organization for direct patient [primary] care that is paid under a

direct patient care [medical service] agreement.

Sec. 117.005 [162.255]. INTERFERENCE PROHIBITED. (a) The

Texas Medical Board [board] or another state agency may not

prohibit, interfere with, initiate a legal or administrative

proceeding against, or impose a fine or penalty against:

(1) a physician or health care practitioner solely

because the physician or practitioner provides direct patient

[primary] care; or

(2) a person solely because the person pays a direct

fee for direct patient [primary] care.

(b) A health insurer, health maintenance organization, or

health care provider as that term is defined by Section 105.001

may not prohibit, interfere with, or initiate a legal proceeding

against:

(1) a physician or health care practitioner solely

because the physician or practitioner provides direct patient

[primary] care; or

(2) a person solely because the person pays a direct

fee for direct patient [primary] care.

Sec. 117.006 [162.256]. REQUIRED DISCLOSURE. A physician

or health care practitioner providing direct patient [primary] care

shall provide written or electronic notice to the patient that a

direct patient care [medical service] agreement for direct patient

[primary] care is not insurance, prior to entering into the

agreement.

SECTION 2. The changes in law made by this Act apply only to

an agreement entered into on or after the effective date of this

Act. An agreement entered into before the effective date of this

Act is governed by the law applicable to the agreement immediately

before the effective date of this Act, and that law is continued in

effect for that purpose.

SECTION 3. This Act takes effect immediately if it receives

a vote of two-thirds of all the members elected to each house, as

provided by Section 39, Article III, Texas Constitution. If this

Act does not receive the vote necessary for immediate effect, this

Act takes effect September 1, 2025.

______________________________
______________________________

President of the Senate
Speaker of the House

I certify that H.B. No. 541 was passed by the House on May 8,

2025, by the following vote: Yeas 144, Nays 1, 2 present, not

voting.

______________________________

Chief Clerk of the House

I certify that H.B. No. 541 was passed by the Senate on May

28, 2025, by the following vote: Yeas 31, Nays 0.

______________________________

Secretary of the Senate

APPROVED: _____________________

Date

_____________________

Governor