SB94 Alabama 2017 Session

Summary

Primary Sponsor

Arthur OrrSenator

Republican

Session

Regular Session 2017

Title

Physician agreements, not subject to regulation as insurance, license to sell or market not required, requirements for agreement established, discontinuance of services under the agreement, Ala. Physicians Direct Pay Act

Summary

SB94 creates a direct-pay framework for physician and dentist agreements that are not treated as insurance and sets rules for formation, disclosures, and when care can be discontinued.

What This Bill Does

It states that physician and dentist direct-pay agreements are not insurance and do not require a separate license beyond maintaining a current medical or dental license. It requires such agreements to be in writing, signed, describe services and fees, specify duration and renewal, and include bold disclosures that the agreement is not insurance and related ACA notes. It allows the provider to discontinue care under defined conditions and requires that any unearned fees be refunded if the patient terminates. It also clarifies that payments under these agreements do not count toward insurance deductibles or out-of-pocket maximums and advises patients to check with their insurer before entering the agreement.

Who It Affects

• Patients who choose to enter into a direct-pay physician or dentist agreement; they would pay for services directly and must understand the agreement is not health insurance.
• Physicians and dentists who offer, market, or enter into direct-pay agreements and their practices; they must follow the written, disclosure, termination, and refund rules and may discontinue care under specified conditions.

Key Provisions

• A physician agreement or dentist agreement is not insurance and is not subject to state insurance laws.
• Offering or entering into such an agreement does not require a separate license or certificate of authority beyond maintaining a current medical or dental license.
• An agreement must be in writing, signed by both parties, describe covered services, specify the periodic and any additional fees, define duration/renewal, and require no more than 12 months of fees paid in advance.
• Disclosures must be conspicuously stated in bold text, including that the agreement is not health insurance and related ACA notes; it also notes that uninsured patients may have ACA penalties and that insured patients may have preventive benefits already covered.
• All unearned fees must be returned to the patient if the patient terminates the agreement.
• Providers may discontinue care for nonpayment, fraud, nonadherence to treatment, abuse, practice closure, or as allowed by applicable medical or dental regulations.
• Payments under the agreement do not count toward the patient’s health insurance deductibles or out-of-pocket maximums, and patients are encouraged to consult their insurer before entering the agreement.
• Effective date: the act becomes law on the first day of the third month after passage and governor approval.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health