I 

118TH CONGRESS 

1ST SESSION H. R. 5287 

To direct the Secretary of Veterans Affairs to establish a pilot program 

to provide veteran health savings accounts to allow veterans to receive 

primary care furnished under non-Department direct primary care service 

arrangements, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

AUGUST 25, 2023 

Mr. ROY (for himself, Mr. CRANE, Mr. GOODEN of Texas, Mrs. MILLER of 

Illinois, Mr. WILLIAMS of Texas, and Mr. BISHOP of North Carolina) introduced the following bill; which was referred to the Committee on Veterans’ Affairs 

A BILL 

To direct the Secretary of Veterans Affairs to establish a 

pilot program to provide veteran health savings accounts 

to allow veterans to receive primary care furnished under 

non-Department direct primary care service arrangements, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Veterans Access to 

5 Direct Primary Care Act’’. 


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1 SEC. 2. PILOT PROGRAM ON ESTABLISHMENT OF VETERAN 

2 HEALTH SAVINGS ACCOUNTS TO ALLOW VET3 ERANS TO ACCESS DIRECT PRIMARY CARE 

4 SERVICE ARRANGEMENTS. 

5 (a) ESTABLISHMENT.—Beginning one year after the 

6 date of the enactment of this Act, the Secretary of Vet7 erans Affairs shall carry out a five-year pilot program 

8 under which the Secretary shall provide eligible veterans 

9 with the option to choose to receive primary care services 

10 furnished by a non-Department of Veterans Affairs health 

11 care provider under a direct primary care service arrange12 ment through the use of a veteran health savings account 

13 described in subsection (c). The pilot program shall be 

14 conducted under the Center for Innovation for Care and 

15 Payment under section 1703E of title 38, United States 

16 Code. 

17 (b) ELIGIBLE VETERAN.—For purposes of the pilot 

18 program under this section, an eligible veteran is a veteran 

19 who is enrolled in the patient enrollment system of the 

20 Department of Veterans Affairs under section 1705 of 

21 title 38, United States Code. 

22 (c) VETERAN HEALTH SAVINGS ACCOUNTS.—The 

23 Secretary shall provide to an eligible veteran who partici24 pates in the pilot program a veterans health savings ac25 count that may be used— 


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1 (1) to purchase primary care services furnished 

2 through a non-Department direct primary care serv3 ice arrangement; and 

4 (2) for associated costs, including— 

5 (A) periodic fees paid to a physician for a 

6 defined set of medical services or for the right 

7 to receive medical services on an as-needed 

8 basis; 

9 (B) amounts paid or prepaid for medical 

10 services designed to screen for, diagnose, cure, 

11 mitigate, treat, or prevent disease and promote 

12 wellness; and 

13 (C) prescription or non-prescription medi14 cines or drugs. 

15 (d) ELIGIBILITY FOR DEPARTMENT MEDICAL

16 CARE.—A veteran who chooses to receive a veteran health 

17 savings account described under subsection (c) may not 

18 receive medical care furnished by the Department of Vet19 erans Affairs that is included in the direct primary care 

20 service arrangement described in such subsection during 

21 the period the veteran participates in the pilot program. 

22 (e) PREVENTION OF FRAUDULENT ACTIVITY.—The 

23 Secretary shall establish a mechanism to prevent fraudu24 lent activity in connection with payments made under this 


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1 section and to ensure participating veterans use health 

2 savings accounts only as authorized under this section. 

3 (f) AMOUNTS DEPOSITED IN ACCOUNTS.—The Sec4 retary of Veterans Affairs shall— 

5 (1) determine the annual amount to be depos6 ited in a veteran health savings account described in 

7 subsection (c) using calculations conducted by the 

8 Secretary and in consultation with an actuarial serv9 ice; and 

10 (2) ensure that each participating eligible vet11 eran receives such amount on an annual basis dur12 ing the period the veteran participates in the pilot 

13 program. 

14 (g) DIRECT PRIMARY CARE SERVICE ARRANGE15 MENT.—In this section, the term ‘‘direct primary care 

16 service arrangement’’ means an agreement under which 

17 a defined set of medical services are provided to a patient 

18 by a physician for fixed periodic fees. 

19 (h) REPORTS.— 

20 (1) IMPLEMENTATION REPORTS.—For each cal21 endar quarter during the two-year period beginning 

22 on the date of the enactment of this Act, the Sec23 retary shall submit to the Committees on Veterans’ 

24 Affairs of the Senate and House of Representatives 

25 a report on the implementation of this section. One 


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1 such report shall include a description of the final 

2 design of the pilot program. 

3 (2) ANNUAL REPORTS.—Not later than one 

4 year after the date on which the final implementa5 tion report required by paragraph (1) is submitted, 

6 and annually thereafter, the Secretary shall submit 

7 to the Committees on Veterans’ Affairs of the Sen8 ate and House of Representatives a report on the re9 sults of the pilot program under this section. 

10 (i) NO ADDITIONAL APPROPRIATIONS.—Amounts re11 quired to carry out this section shall be made available 

12 from amounts otherwise authorized to be appropriated for 

13 the Veterans Health Administration. 

14 (j) TERMINATION.—The authority of the Secretary to 

15 deposit funds in a veteran health savings account under 

16 this section shall terminate on the date that is five years 

17 after the date of the enactment of this Act. 

Æ 


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