Direct Primary Care Accessibility Act of 2021
Bill: H.R.3436 | Sponsor: Rep. Rosendale Sr., Matthew M. (R-MT)
Policy area: Health

Summary:
Direct Primary Care Accessibility Act of 2021
This bill exempts from federal regulation as health insurance coverage direct primary care arrangements under which a health care provider serves an individual in return for a direct fee, such as a membership fee or a fee for each service. These arrangements must include a written agreement that describes the specifics of the arrangement, including the items and services to be provided and the individual's payment obligation.

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 Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Direct Primary Care Accessibility 
Act of 2021''.

SEC. 2. EXEMPTING CERTAIN DIRECT PRIMARY CARE ARRANGEMENTS FROM 
              REGULATION AS HEALTH INSURANCE COVERAGE.

    Section 2791(b) of the Public Health Service Act (42 U.S.C. 300gg-
91(b)) is amended--
            (1) in paragraph (1), by inserting ``, except that such 
        term shall not include a direct primary care arrangement (as 
        defined in paragraph (6))'' before the period; and
            (2) by adding at the end the following new paragraph:
            ``(6) Direct primary care arrangement.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), the term `direct primary care 
                arrangement' means an arrangement under which an item 
                or service is furnished by a health care provider to an 
                individual in return for a direct fee. Such a fee may 
                include--
                            ``(i) a monthly retainer;
                            ``(ii) a membership fee;
                            ``(iii) a subscription fee; or
                            ``(iv) a fee for a service, visit, or 
                        episode of care.
                    ``(B) Exception.--The term `direct primary care 
                arrangement' shall not include any arrangement unless--
                            ``(i) a copy of such arrangement is 
                        provided to the individual entering into such 
                        agreement (or the legal representative of such 
                        individual); and
                            ``(ii) such agreement--
                                    ``(I) is in writing;
                                    ``(II) describes the items and 
                                services to be provided in exchange for 
                                payment of a direct fee (as described 
                                in subparagraph (A));
                                    ``(III) specifies the direct fee 
                                required and any additional fees to be 
                                paid by a third party;
                                    ``(IV) specifies the individual's 
                                payment obligation; and
                                    ``(V) prohibits the provider from 
                                charging or receiving additional 
                                compensation for items and services 
                                included in the direct fee.''.
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