Kansas

Quick Facts

Key Provisions

• A direct primary care agreement is explicitly defined as not constituting insurance and is therefore exempt from regulation under the Kansas Insurance Code (K.S.A. 40-4603).
• All DPC arrangements must be established through a written agreement that clearly specifies the primary care services provided, the periodic fee, and the duration of the contract.
• The agreement must prominently disclose that it is not an insurance policy, does not cover services like hospitalization or specialty care, and that the patient should maintain separate health coverage.
• Either the provider or the patient may terminate the DPC agreement at any time by providing at least 30 days' written notice to the other party.
• Upon termination of an agreement, the provider is required to refund the patient a pro-rated amount for any fees paid in advance for services not yet rendered.
• The law applies to primary care providers licensed in Kansas, including physicians (MDs and DOs). Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs) may also operate DPC practices under their respective licensing and supervision requirements.
• Services offered under a DPC agreement are limited to routine primary care, such as wellness exams, consultations, and basic diagnostic tests. The agreement cannot include coverage for services typically handled by insurance, like surgery or emergency room visits.
• Providers are prohibited from billing a patient's insurance plan for any services that are already covered under the DPC agreement's periodic fee.

Medication Dispensing

In Kansas, DPC practices can dispense medications directly to their patients by following the state's general physician dispensing laws. Under K.S.A. 65-1637 et seq., licensed physicians are permitted to dispense pre-packaged drugs in reasonable quantities from their office without needing a separate pharmacy license. These dispensing activities must comply with all applicable rules set forth by the Kansas State Board of Pharmacy (K.A.R. 68-1 et seq.). The 2014 DPC legislation did not create any special exemptions or additional requirements for DPC practices, so they operate under the same dispensing framework as any other physician's office in the state.

Medicaid Provisions

Kansas law ensures that patients can participate in a DPC practice without jeopardizing their eligibility for Medicaid. The state's DPC statute (K.S.A. 40-4601 et seq.) explicitly clarifies that a direct primary care agreement is not a form of insurance, and therefore does not count as disqualifying health coverage for Medicaid purposes. The legislation does not include any specific provisions for DPC pilot programs within the state's Medicaid system or for state employee health plans. Patients with these plans are generally free to enter into DPC agreements for primary care while using their traditional insurance for other medical needs.