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We will discuss “direct pay” practice arrangements (also referred to as “direct primary care”) – a care delivery model in which patients pay the practice a flat monthly fee in exchange for providing a predetermined set of health care services. We will summarize the approaches taken by those states that currently regulate this delivery model and highlight some of the key regulatory and legal issues associated with direct pay arrangements. We will also discuss how employers can pay for direct pay programs as a part of their benefit plans.