Ohio

Quick Facts

Key Provisions

• A Direct Primary Care agreement is explicitly defined as not being insurance and is exempt from state insurance laws (Ohio Revised Code Title XXXIX) as long as it meets specific statutory requirements.
• The agreement must be a formal written contract between a patient (or their legal representative) and a healthcare provider.
• A mandatory disclosure must be included, conspicuously stating that the agreement is not health insurance, is not regulated by state insurance laws, and does not meet any federal individual health insurance mandates.
• The contract must clearly describe the primary care services to be provided and specify the periodic fee amount, as well as any additional fees for services not covered by the membership.
• Providers are prohibited from charging any fees for services covered by the periodic membership fee, other than those explicitly detailed in the agreement.
• Either the patient or the provider may terminate the agreement by providing written notice. The termination can be effective immediately or up to 60 days after the notice is received.
• The law protects patients by prohibiting practices from charging any termination penalties or fees if the agreement is ended.
• The statute permits a third party, such as an employer or family member, to pay the periodic fees on behalf of the patient.
• The law applies to any licensed "health care provider," which includes Medical Doctors (MDs) and Doctors of Osteopathic Medicine (DOs), and may also include other clinicians like Nurse Practitioners (NPs) and Physician Assistants (PAs) practicing within their legal scope.

Medication Dispensing

In Ohio, medication dispensing rules for DPC practices are governed by the Ohio Board of Pharmacy. A key distinction exists based on practice structure. A single-prescriber practice, where the sole owner is a licensed prescriber (such as an MD or DO), is exempt from needing a Terminal Distributor of Dangerous Drugs (TDDD) license to dispense medications directly to patients. However, if a practice has multiple prescribers or is not solely owned by a single prescriber, it must obtain a TDDD license to dispense medications on-site.