Section 1 Short title
This Act may be cited as the “Direct Primary Care Accessibility Act of 2023”.
Direct Primary Care Accessibility Act of 2023
A BILL
To amend title XXVII of the Public Health Service Act to exempt certain direct primary care arrangements from regulation as health insurance coverage.
Sec. 2 Exempting certain direct primary care arrangements from regulation as health insurance coverage
Section 2791(b) of the Public Health Service Act (42 U.S.C. 300gg–91(b)) is amended—
in paragraph (1), by inserting “, except that such term shall not include a direct primary care arrangement (as defined in paragraph (6))” before the period; and
by adding at the end the following new paragraph:
“(6) Direct primary care arrangement
“(A) In general—Except as provided in subparagraph (B), the term “direct primary care arrangement” means an arrangement under which an item or service is furnished by a health care provider to an individual in return for a direct fee. Such a fee may include—
“(i) a monthly retainer;
“(ii) a membership fee;
“(iii) a subscription fee; or
“(iv) a fee for a service, visit, or episode of care.
“(B) Exception—The term “direct primary care arrangement” shall not include any arrangement unless—
“(i) a copy of such arrangement is provided to the individual entering into such agreement (or the legal representative of such individual); and
“(ii) such agreement—
“(I) is in writing;
“(II) describes the items and services to be provided in exchange for payment of a direct fee (as described in subparagraph (A));
“(III) specifies the direct fee required and any additional fees to be paid by a third party;
“(IV) specifies the individual’s payment obligation; and
“(V) prohibits the provider from charging or receiving additional compensation for items and services included in the direct fee.”