H.R. 6317 — what changed
Primary Care Enhancement Act of 2018
From Introduced in House to Reported in House. 1 section amended and 1 added between Introduced in House and Reported in House.
Section 1 Short title
added This Act may be cited as the “Primary Care Enhancement Act of 2018”.
removed
“(D) Treatment of direct primary care service arrangements
removed
“(i) In general—A direct primary care service arrangement shall not be treated as a health plan for purposes of subparagraph (A)(ii).
removed
“(ii) Direct primary care service arrangement—For purposes of this paragraph—
removed
“(I) In general—The term “direct primary care service arrangement” means, with respect to any individual, an arrangement under which such individual is provided medical care (as defined in section 213(d)) consisting solely of primary care services (as defined in section 1833(x)(2)(B) of the Social Security Act) provided by primary care practitioners (as defined in section 1833(x)(2)(A) of the Social Security Act, determined without regard to clause (ii) thereof), if the sole compensation for such care is a fixed periodic fee.
removed
“(II) Limitation—With respect to any individual for any month, such term shall not include any arrangement if the aggregate fees for all direct primary care service arrangements (determined without regard to this subclause) with respect to such individual for such month exceed $150 (twice such dollar amount in the case of an individual with any direct primary care service arrangement (as so determined) that covers more than one individual).
removed
“(iii) Certain services specifically excluded from treatment as primary care services—For purposes of this paragraph, the term “primary care services” shall not include—
removed
“(I) procedures that require the use of general anesthesia,
removed
“(II) prescription drugs (other than vaccines), and
removed
“(III) laboratory services not typically administered in an ambulatory primary care setting.”
removed
“(v) any direct primary care service arrangement.”
removed
“(iii) in the case of the dollar amount in subsection (c)(1)(D)(ii)(II) for taxable years beginning in calendar years after 2019, “calendar year 2018”.”
removed
“(18) in the case of a direct primary care service arrangement (as defined in section 223(c)(1)(D)(ii)) which is provided in connection with employment, the aggregate fees for such arrangement for such employee.”
Sec. 2 Treatment of direct primary care service arrangements
addedadded “(D) Treatment of direct primary care service arrangements
added “(i) In general—A direct primary care service arrangement shall not be treated as a health plan for purposes of subparagraph (A)(ii).
added “(ii) Direct primary care service arrangement—For purposes of this paragraph—
added “(I) In general—The term “direct primary care service arrangement” means, with respect to any individual, an arrangement under which such individual is provided medical care (as defined in section 213(d)) consisting solely of primary care services (as defined in section 1833(x)(2)(B) of the Social Security Act) provided by primary care practitioners (as defined in section 1833(x)(2)(A) of the Social Security Act, determined without regard to clause (ii) thereof), if the sole compensation for such care is a fixed periodic fee.
added “(II) Limitation—With respect to any individual for any month, such term shall not include any arrangement if the aggregate fees for all direct primary care service arrangements (determined without regard to this subclause) with respect to such individual for such month exceed $150 (twice such dollar amount in the case of an individual with any direct primary care service arrangement (as so determined) that covers more than one individual).
added “(iii) Certain services specifically excluded from treatment as primary care services—For purposes of this paragraph, the term “primary care services” shall not include—
added “(I) procedures that require the use of general anesthesia,
added “(II) prescription drugs (other than vaccines), and
added “(III) laboratory services not typically administered in an ambulatory primary care setting.”
added “(v) any direct primary care service arrangement.”
added “(iii) in the case of the dollar amount in subsection (c)(1)(D)(ii)(II) for taxable years beginning in calendar years after 2019, “calendar year 2018”.”
added “(18) in the case of a direct primary care service arrangement (as defined in section 223(c)(1)(D)(ii)) which is provided in connection with employment, the aggregate fees for such arrangement for such employee.”