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I
117TH CONGRESS
1ST SESSION H. R. 3436
To amend title XXVII of the Public Health Service Act to exempt certain
direct primary care arrangements from regulation as health insurance
coverage.
IN THE HOUSE OF REPRESENTATIVES
MAY 20, 2021
Mr. ROSENDALE introduced the following bill; which was referred to the
Committee on Energy and Commerce
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.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘Direct Primary Care
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Accessibility Act of 2021’’.
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•HR 3436 IH
SEC. 2. EXEMPTING CERTAIN DIRECT PRIMARY CARE AR-
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RANGEMENTS
FROM
REGULATION
AS
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HEALTH INSURANCE COVERAGE.
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Section 2791(b) of the Public Health Service Act (42
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U.S.C. 300gg–91(b)) is amended—
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(1) in paragraph (1), by inserting ‘‘, except that
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such term shall not include a direct primary care ar-
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rangement (as defined in paragraph (6))’’ before the
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period; and
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(2) by adding at the end the following new
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paragraph:
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‘‘(6) DIRECT PRIMARY CARE ARRANGEMENT.—
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‘‘(A) IN GENERAL.—Except as provided in
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subparagraph (B), the term ‘direct primary
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care arrangement’ means an arrangement
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under which an item or service is furnished by
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a health care provider to an individual in return
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for a direct fee. Such a fee may include—
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‘‘(i) a monthly retainer;
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‘‘(ii) a membership fee;
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‘‘(iii) a subscription fee; or
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‘‘(iv) a fee for a service, visit, or epi-
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sode of care.
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‘‘(B) EXCEPTION.—The term ‘direct pri-
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mary care arrangement’ shall not include any
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arrangement unless—
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•HR 3436 IH
‘‘(i) a copy of such arrangement is
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provided to the individual entering into
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such agreement (or the legal representative
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of such individual); and
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‘‘(ii) such agreement—
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‘‘(I) is in writing;
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‘‘(II) describes the items and
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services to be provided in exchange for
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payment of a direct fee (as described
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in subparagraph (A));
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‘‘(III) specifies the direct fee re-
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quired and any additional fees to be
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paid by a third party;
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‘‘(IV) specifies the individual’s
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payment obligation; and
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‘‘(V) prohibits the provider from
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charging or receiving additional com-
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pensation for items and services in-
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cluded in the direct fee.’’.
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Æ
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