I 
119TH CONGRESS 
1ST SESSION H. R. 1140 
To amend the Internal Revenue Code of 1986 to allow individuals with 
direct medical care service arrangement to remain eligible individuals 
for purposes of health savings accounts, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 7, 2025 
Mr. ROY (for himself, Mr. BIGGS of Arizona, and Mr. MOORE of Alabama) 
introduced the following bill; which was referred to the Committee on 
Ways and Means 
A BILL 
To amend the Internal Revenue Code of 1986 to allow indi-
viduals with direct medical care service arrangement to 
remain eligible individuals for purposes of health savings 
accounts, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Direct Medical Care 
Freedom Act of 2025’’. 
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SEC. 2. TREATMENT OF DIRECT MEDICAL CARE SERVICE 
ARRANGEMENTS. 
(a) IN GENERAL.—Section 223(c)(1) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following new subparagraph: 
‘‘(E) TREATMENT
OF
DIRECT
MEDICAL 
CARE SERVICE ARRANGEMENTS.— 
‘‘(i) IN GENERAL.—A direct medical 
care service arrangement shall not be 
treated as a health plan for purposes of 
subparagraph (A)(ii). 
‘‘(ii) DIRECT MEDICAL CARE SERVICE 
ARRANGEMENT.—For purposes of this 
paragraph— 
‘‘(I) IN GENERAL.—The term ‘di-
rect medical care service arrangement’ 
means, with respect to any individual, 
an arrangement under which such in-
dividual is provided medical care pro-
vided by medical care practitioners if 
the sole compensation for such care is 
a fixed periodic fee. 
‘‘(II) APPLICATION TO PRIMARY 
CARE, SPECIALTY CARE, ETC.—An ar-
rangement shall not fail to be treated 
as a direct medical care service ar-
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rangement merely because such ar-
rangement is restricted to any subset 
of medical care or medical care practi-
tioners. 
‘‘(iii) 
MEDICAL
CARE
PRACTI-
TIONER.—For purposes of this paragraph, 
the term ‘medical care practitioner’ means 
an individual who is— 
‘‘(I) a physician (as defined in 
section 1861(r)(1) of the Social Secu-
rity Act), or 
‘‘(II) a nurse practitioner, clinical 
nurse specialist, or physician assistant 
(as such terms are defined in section 
1861(aa)(5) of the Social Security 
Act). 
‘‘(iv) MEDICAL CARE.—For purposes 
of this paragraph, the term ‘medical care’ 
has the meaning given such term in section 
213(d)).’’. 
(b) DIRECT MEDICAL CARE SERVICE ARRANGEMENT 
FEES
TREATED
AS
MEDICAL
EXPENSES.—Section 
223(d)(2)(C) of such Code is amended by striking ‘‘or’’ 
at the end of clause (iii), by striking the period at the 
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end of clause (iv) and inserting ‘‘, or’’, and by adding at 
the end the following new clause: 
‘‘(v) any direct medical care service 
arrangement.’’. 
(c) REPORTING OF DIRECT MEDICAL CARE SERVICE 
ARRANGEMENT FEES ON W–2.—Section 6051(a) of such 
Code is amended by striking ‘‘and’’ at the end of para-
graph (16), by striking the period at the end of paragraph 
(17) and inserting ‘‘, and’’, and by inserting after para-
graph (17) the following new paragraph: 
‘‘(18) in the case of a direct medical care serv-
ice 
arrangement 
(as 
defined 
in 
section 
223(c)(1)(E)(ii)) which is provided in connection 
with employment, the aggregate fees for such ar-
rangement for such employee.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to months beginning after Decem-
ber 31, 2024, in taxable years ending after such date. 
Æ 
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