[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1719 Introduced in Senate (IS)]
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119th CONGRESS
1st Session
S. 1719
To amend the Internal Revenue Code of 1986 to provide for the treatment
of direct primary care service arrangements as medical care, to provide
that such arrangements do not disqualify deductible health savings
account contributions, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 12, 2025
Mr. Cassidy (for himself, Mrs. Shaheen, Mr. Scott of South Carolina,
Mr. Kelly, and Mr. Lankford) introduced the following bill; which was
read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend the Internal Revenue Code of 1986 to provide for the treatment
of direct primary care service arrangements as medical care, to provide
that such arrangements do not disqualify deductible health savings
account contributions, 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 Care Enhancement Act of
2025''.
SEC. 2. TREATMENT OF DIRECT PRIMARY CARE SERVICE ARRANGEMENTS.
(a) Amount Treated as Medical Care.--
(1) In general.--Section 213(d)(1) of the Internal Revenue
Code of 1986 is amended by striking ``or'' at the end of
subparagraph (C), by striking the period at the end of
subparagraph (D) and inserting ``, or'', and by inserting after
subparagraph (D) the following new subparagraph:
``(E) for direct primary care service
arrangements.''.
(2) Limitation.--Section 213(d)(1) of such Code, as amended
by paragraph (1), is further amended by adding at the end the
following: ``In the case of a direct care primary service
arrangement, only eligible fee amounts (as defined in paragraph
(13)) shall be taken into account under subparagraph (E).''.
(3) Definitions.--Section 213(d) of such Code is amended by
inserting after paragraph (11) the following new paragraphs:
``(12) Direct primary care service arrangement.--
``(A) In general.--The term `direct primary care
service arrangement' means, with respect to any
individual, an arrangement under which such individual
is provided medical care (as defined in paragraph (1),
determined without regard to subparagraph (E) thereof)
consisting solely of primary care services provided by
primary care practitioners (as defined in section
1833(x)(2)(A) of the Social Security Act, determined
without regard to clause (ii) thereof), if the sole
compensation for such care is a fixed periodic fee.
``(B) Certain services specifically excluded from
treatment as primary care services.--For purposes of
this paragraph, the term `primary care services' shall
not include--
``(i) procedures that require the use of
general anesthesia, and
``(ii) laboratory services not typically
administered in an ambulatory primary care
setting.
The Secretary, after consultation with the Secretary of
Health and Human Services, shall issue regulations or
other guidance regarding the application of this
subparagraph.
``(13) Eligible fee amount.--
``(A) In general.--The term `eligible fee amount'
means, with respect to any individual for any month,
the amount of fixed periodic fees paid for a direct
care primary service arrangement, to the extent that
the aggregate fees for all direct primary care service
arrangements with respect to such individual for such
month do not exceed $150 (twice such dollar amount in
the case of an individual with any direct primary care
service arrangement that covers more than one
individual).
``(B) Indexing.--In the case of any taxable year
beginning in a calendar year after 2026, the $150
amount contained in subparagraph (A) shall be increased
by an amount equal to--
``(i) such dollar amount, multiplied by
``(ii) the cost-of-living adjustment
determined under section 1(f)(3) for the
calendar year in which such taxable year begins
determined by substituting `calendar year 2025'
for `calendar year 2016' in subparagraph
(A)(ii) thereof.
If any increase under the preceding sentence is not a
multiple of $10, such increase shall be rounded to the
nearest multiple of $10.''.
(b) Health Savings Accounts.--Section 223(c) of the Internal
Revenue Code of 1986 is amended by adding at the end the following new
paragraph:
``(6) Treatment of direct primary care service
arrangements.--A direct care primary service arrangement (as
defined in section 213(d)(12))--
``(A) shall not be treated as a health plan for
purposes of paragraph (1)(A)(ii), and
``(B) shall not be treated as insurance for
purposes of subsection (d)(2)(B).''.
(c) Reporting of Direct Primary Care Service Arrangement Fees on W-
2.--Section 6051(a) of the Internal Revenue Code of 1986 is amended by
striking ``and'' at the end of paragraph (16), by striking the period
at the end of paragraph (17) and inserting ``, and'', and by inserting
after paragraph (17) the following new paragraph:
``(18) in the case of a direct primary care service
arrangement (as defined in section 213(d)(12)) which is
provided in connection with employment, the aggregate fees for
such arrangement for such employee.''.
(d) Effective Date.--The amendments made by this section shall
apply to months beginning after December 31, 2025, in taxable years
ending after such date.
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