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) in-
troduced the following bill; which was referred to the Committee on Vet-
erans’ 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 arrange-
ments, 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 ‘‘Veterans Access to 
Direct Primary Care Act’’. 
VerDate Sep 11 2014 
01:49 Aug 26, 2023
Jkt 039200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H5287.IH
H5287
kjohnson on DSK79L0C42PROD with BILLS
SEC. 2. PILOT PROGRAM ON ESTABLISHMENT OF VETERAN 
HEALTH SAVINGS ACCOUNTS TO ALLOW VET-
ERANS TO ACCESS DIRECT PRIMARY CARE 
SERVICE ARRANGEMENTS. 
(a) ESTABLISHMENT.—Beginning one year after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall carry out a five-year pilot program 
under which the Secretary shall provide eligible veterans 
with the option to choose to receive primary care services 
furnished by a non-Department of Veterans Affairs health 
care provider under a direct primary care service arrange-
ment through the use of a veteran health savings account 
described in subsection (c). The pilot program shall be 
conducted under the Center for Innovation for Care and 
Payment under section 1703E of title 38, United States 
Code. 
(b) ELIGIBLE VETERAN.—For purposes of the pilot 
program under this section, an eligible veteran is a veteran 
who is enrolled in the patient enrollment system of the 
Department of Veterans Affairs under section 1705 of 
title 38, United States Code. 
(c) VETERAN HEALTH SAVINGS ACCOUNTS.—The 
Secretary shall provide to an eligible veteran who partici-
pates in the pilot program a veterans health savings ac-
count that may be used— 
VerDate Sep 11 2014 
01:49 Aug 26, 2023
Jkt 039200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H5287.IH
H5287
kjohnson on DSK79L0C42PROD with BILLS
(1) to purchase primary care services furnished 
through a non-Department direct primary care serv-
ice arrangement; and 
(2) for associated costs, including— 
(A) periodic fees paid to a physician for a 
defined set of medical services or for the right 
to receive medical services on an as-needed 
basis; 
(B) amounts paid or prepaid for medical 
services designed to screen for, diagnose, cure, 
mitigate, treat, or prevent disease and promote 
wellness; and 
(C) prescription or non-prescription medi-
cines or drugs. 
(d) 
ELIGIBILITY
FOR
DEPARTMENT
MEDICAL 
CARE.—A veteran who chooses to receive a veteran health 
savings account described under subsection (c) may not 
receive medical care furnished by the Department of Vet-
erans Affairs that is included in the direct primary care 
service arrangement described in such subsection during 
the period the veteran participates in the pilot program. 
(e) PREVENTION OF FRAUDULENT ACTIVITY.—The 
Secretary shall establish a mechanism to prevent fraudu-
lent activity in connection with payments made under this 
VerDate Sep 11 2014 
01:49 Aug 26, 2023
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5287.IH
H5287
kjohnson on DSK79L0C42PROD with BILLS
section and to ensure participating veterans use health 
savings accounts only as authorized under this section. 
(f) AMOUNTS DEPOSITED IN ACCOUNTS.—The Sec-
retary of Veterans Affairs shall— 
(1) determine the annual amount to be depos-
ited in a veteran health savings account described in 
subsection (c) using calculations conducted by the 
Secretary and in consultation with an actuarial serv-
ice; and 
(2) ensure that each participating eligible vet-
eran receives such amount on an annual basis dur-
ing the period the veteran participates in the pilot 
program. 
(g) DIRECT PRIMARY CARE SERVICE ARRANGE-
MENT.—In this section, the term ‘‘direct primary care 
service arrangement’’ means an agreement under which 
a defined set of medical services are provided to a patient 
by a physician for fixed periodic fees. 
(h) REPORTS.— 
(1) IMPLEMENTATION REPORTS.—For each cal-
endar quarter during the two-year period beginning 
on the date of the enactment of this Act, the Sec-
retary shall submit to the Committees on Veterans’ 
Affairs of the Senate and House of Representatives 
a report on the implementation of this section. One 
VerDate Sep 11 2014 
01:49 Aug 26, 2023
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5287.IH
H5287
kjohnson on DSK79L0C42PROD with BILLS
such report shall include a description of the final 
design of the pilot program. 
(2) ANNUAL
REPORTS.—Not later than one 
year after the date on which the final implementa-
tion report required by paragraph (1) is submitted, 
and annually thereafter, the Secretary shall submit 
to the Committees on Veterans’ Affairs of the Sen-
ate and House of Representatives a report on the re-
sults of the pilot program under this section. 
(i) NO ADDITIONAL APPROPRIATIONS.—Amounts re-
quired to carry out this section shall be made available 
from amounts otherwise authorized to be appropriated for 
the Veterans Health Administration. 
(j) TERMINATION.—The authority of the Secretary to 
deposit funds in a veteran health savings account under 
this section shall terminate on the date that is five years 
after the date of the enactment of this Act. 
Æ 
VerDate Sep 11 2014 
01:49 Aug 26, 2023
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6301
E:\BILLS\H5287.IH
H5287
kjohnson on DSK79L0C42PROD with BILLS