A bill for an act relating to insurance coverage for health care services provided pursuant to a referral by an out-of-network primary care provider.

This bill requires insurance companies to cover health care services referred by a patient's out-of-network primary care provider (PCP) without denying coverage solely because the PCP isn't in-network. It also mandates that cost-sharing (like deductibles or copays) for these services must match what would apply if the PCP were in-network. Insurance companies may ask for proof the PCP has a direct primary care agreement with the patient, but the rule only applies to referrals made on or after July 1, 2026.