Primary and Virtual Care Affordability Act
Bill: H.R.5541 | Sponsor: Rep. Schneider, Bradley Scott (D-IL)
Policy area: Taxation

Summary:
Primary and Virtual Care Affordability Act
This bill extends until December 31, 2023, the exemption for telehealth services from certain high deductible health plan rules. It also provides a high deductible health plan safe harbor for the absence of a deductible for certain primary care services provided in any plan year beginning on or before December 31, 2023 (COVID-19 emergency period).
The Government Accountability Office must complete a study, and report on, the effects of the safe harbor for certain primary care services provided during the COVID-19 emergency period.

To amend the Internal Revenue Code of 1986 to extend the exemption for 
telehealth services from certain high deductible health plan rules, and 
                          for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Primary and Virtual Care 
Affordability Act''.

SEC. 2. EXEMPTION FOR TELEHEALTH SERVICES.

    (a) In General.--Subparagraph (E) of section 223(c)(2) of the 
Internal Revenue Code of 1986 is amended by striking ``December 31, 
2021'' and inserting ``December 31, 2023''.
    (b) Certain Coverage Disregarded.--Clause (ii) of section 
223(c)(1)(B) of the Internal Revenue Code of 1986 is amended by 
striking ``December 31, 2021'' and inserting ``December 31, 2023''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date of the enactment of this Act.

SEC. 3. HIGH DEDUCTIBLE HEALTH PLAN SAFE HARBOR FOR NO DEDUCTIBLE FOR 
              CERTAIN PRIMARY CARE SERVICES PROVIDED DURING THE COVID 
              EMERGENCY.

    (a) In General.--Paragraph (2) of section 223(c) of the Internal 
Revenue Code of 1986 is amended by adding at the end the following new 
subparagraph:
                    ``(G) Safe harbor for absence of deductible for 
                certain primary care services provided during the covid 
                emergency.--
                            ``(i) In general.--A plan shall not fail to 
                        be treated as a high deductible health plan by 
                        reason of failing to have a deductible for 
                        primary care services provided by a qualified 
                        provider in any plan year beginning on or 
                        before December 31, 2023.
                            ``(ii) Primary care services.--For purposes 
                        of clause (i), the term `primary care services' 
                        means services provided by primary care 
                        practitioners (as defined in section 
                        1833(x)(2)(A)) of the Social Security Act.
                            ``(iii) Qualified provider.--For purposes 
                        of clause (i), the term `qualified provider' 
                        means a general practitioner, family physician, 
                        general internist, obstetrician, gynecologist, 
                        pediatrician, geriatric physician, advanced 
                        practice registered nurse, or physician 
                        assistant acting in accordance with State 
                        laws.''.
    (b) Effective Date.--The amendment made by this section shall apply 
to plan years beginning after December 31, 2019.

SEC. 4. STUDY AND REPORTS.

    (a) Study.--The Comptroller General of the United States shall 
complete a study on the effects of the safe harbor for certain primary 
care services provided during the COVID emergency under section 
223(c)(2)(G) of the Internal Revenue Code of 1986 (as added by section 
3).
    (b) Reports.--
            (1) Interim report.--Not later than 365 days after the date 
        of the enactment of this Act, the Comptroller General of the 
        United States shall provide a report to Congress containing an 
        analysis of the results of the study under subsection (a). Such 
        report shall contain--
                    (A) an analysis of the effects of the safe harbor 
                on--
                            (i) whether plan sponsors opted to 
                        incorporate changes to their benefit design;
                            (ii) insurance premiums;
                            (iii) enrollment in high deductible health 
                        plans;
                            (iv) utilization of primary care visits, 
                        telehealth visits, emergency department visits, 
                        and hospital admissions; and
                            (v) the rate of employer implementation of 
                        flexibilities in changes to benefit design; and
                    (B) comparisons of patient engagement with services 
                for those whose employer incorporated flexibilities 
                into their benefit design and those who did not do so.
            (2) Final report.--Not later than 365 days after the 
        interim report under paragraph (1) is issued, the Comptroller 
        General of the United States shall provide a final report to 
        Congress containing a comprehensive analysis of the results of 
        the study under subsection (a). Such report shall include 
        updated findings, analyses, and comparisons described in 
        paragraph (1).
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