State Resources Directory¶

Overview¶

Regulations, licensing, and resources vary significantly by state. This directory provides guidance on finding state-specific information essential for starting and operating a DPC practice.

Important: This directory provides guidance on WHERE to find information, not the information itself. State regulations change; always verify current requirements with official sources.

How to Use This Guide¶

For each state you practice in (or plan to practice in), you need to research:

1. DPC-specific laws - Is there enabling legislation?
2. Medical licensing - State medical board requirements
3. Business registration - Secretary of State requirements
4. Corporate practice - Any restrictions on medical practice ownership
5. Insurance regulation - State insurance department stance on DPC

Key State Resources by Category¶

Medical Licensing¶

Find your State Medical Board: - Search "[State] Medical Board" or "[State] Board of Medical Examiners" - Federation of State Medical Boards directory: fsmb.org

What to check: - License status and renewal - Practice notification requirements - Supervision requirements (if hiring NPs/PAs) - Telehealth rules - Advertising restrictions - Documentation requirements

Business Registration¶

Find your Secretary of State: - Search "[State] Secretary of State Business" - National Association of Secretaries of State: nass.org

What to check: - Entity formation requirements (LLC, PLLC, PC) - Name availability and registration - Annual report requirements - Registered agent requirements - Fees and timelines

DPC Legislation¶

Research approach: - Search "[State] Direct Primary Care law" - Check state legislature website - Review DPC Alliance resources - Consult healthcare attorney

What to find: - Whether DPC-specific legislation exists - Required disclosures in DPC agreements - Service limitations (if any) - Fee limitations (if any)

Insurance Regulation¶

Find your State Insurance Department: - Search "[State] Department of Insurance" - NAIC directory: naic.org

What to check: - Any guidance or rulings on DPC - Confirmation DPC is not regulated as insurance - Any registration or disclosure requirements

Tax and Revenue¶

Find your State Tax Authority: - Search "[State] Department of Revenue" or "[State] Tax Commission"

What to check: - State business tax requirements - Sales tax applicability (usually medical services exempt) - Payroll tax requirements (if hiring)

State-by-State Quick Reference¶

Finding Your State's Information¶

For each state, search for:

States with Notable DPC Legislation¶

The following states have enacted significant DPC legislation (as of 2024). Verify current status directly:

Early Adopters: - Washington (first DPC law, 2007) - Oregon - Utah - West Virginia

Comprehensive Laws: - Texas - Louisiana - Oklahoma - Arizona - Florida - Idaho

Growing List: Many other states have enacted DPC-related legislation. The landscape continues to evolve.

States Without Specific DPC Laws: Some states operate DPC without specific legislation. DPC may function under general medical practice law or regulatory interpretation.

Corporate Practice of Medicine by State¶

This doctrine affects who can own a medical practice.

Strong Restrictions: - California - Texas - New York - Illinois - Ohio - Iowa - Colorado

Moderate/Limited Restrictions: - Many other states have some form of restriction

Few/No Restrictions: - Some states allow broad corporate ownership

Action: Research your specific state; consult healthcare attorney.

Medicare Considerations by State¶

Medicare rules are federal, but implementation involves state carriers:

Medicare Administrative Contractors (MACs): - Different MACs serve different states - Opt-out procedures go through your MAC - Find your MAC: CMS.gov

State Medical Association Resources¶

State medical associations often provide: - Practice startup resources - Attorney referrals (healthcare law) - Legislative updates - Advocacy on DPC issues - CME and education

Finding Yours: - Search "[State] Medical Association" - Or "[State] Academy of Family Physicians" - Or check AAFP state chapter list

Research Checklist: State Requirements¶

Use this checklist when researching your state:

Licensing¶

• Verified medical license current and in good standing
• Reviewed practice notification requirements
• Understood supervision requirements (NP/PA if applicable)
• Reviewed telehealth regulations
• Checked advertising rules

Business Formation¶

• Researched entity requirements for medical practices
• Checked corporate practice of medicine rules
• Confirmed entity naming requirements
• Reviewed annual filing requirements

DPC Specific¶

• Determined if DPC-specific legislation exists
• If yes, read the actual statute
• Identified required disclosures
• Confirmed no conflicting insurance regulations
• Documented compliance approach

Other Regulatory¶

• Confirmed state business tax requirements
• Reviewed sales tax applicability
• Checked any local business license requirements
• Confirmed DEA registration addressed
• Reviewed PDMP requirements

Getting Help¶

Healthcare Attorneys¶

How to Find: - State bar association referral - State medical association referral - DPC community recommendations - Search "[State] healthcare attorney"

What to Look For: - Healthcare law specialization - DPC/physician practice experience - Licensed in your state - Reasonable fees for startup review

Accountants/CPAs¶

What to Look For: - Healthcare practice experience - Familiarity with entity structures - Understanding of medical practice accounting - Local knowledge

Staying Current¶

State regulations change. Stay informed: - Join state medical association - Follow state DPC community - Monitor legislative sessions - Maintain relationship with healthcare attorney - Participate in national DPC organizations (they track state issues)

Resources¶

• State DPC Laws Overview - General legal framework
• DPC Alliance - State resources section
• Federation of State Medical Boards - Licensing information
• NAIC - Insurance department directory

Important Disclaimer¶

This directory provides general guidance for research purposes. It is not legal advice and may not reflect current state requirements.

Always: - Verify information with official state sources - Consult with a healthcare attorney licensed in your state - Confirm current requirements before making decisions

Next Steps¶

• Research your specific state using this guide
• DPC Organizations - Connect with community resources
• State DPC Laws Overview - Legal framework