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Medicaid Primary Care Improvement Act
To facilitate direct primary care arrangements under Medicaid.
Summary
This bill clarifies that Medicaid programs are permitted to provide medical assistance for primary care services through direct primary care arrangements, in which individuals pay a fixed periodic fee directly to a primary care provider for services. The bill allows states to implement direct primary care arrangements through their Medicaid state plans, waivers, or Medicaid managed care organizations. Within one year of enactment, the Secretary of Health and Human Services must hold a stakeholder meeting and issue guidance to states on implementing direct primary care arrangements under Medicaid. Within two years, the Secretary must submit a report to Congress analyzing the extent to which states are using this model, and evaluating the quality and cost of care provided through direct primary care arrangements. The bill clarifies that it does not alter Medicaid cost-sharing requirements or limit medical assistance to only direct primary care arrangements.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
- Rep. Crenshaw, Dan [R-TX-2] (R-TX)
7 cosponsors
Money behind the sponsor
Top reported contributors to Dan Crenshaw’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.
- NULL $228,839
- CAMDEN PROPERTY TRUST $19,800
- MCCORD DEVELOPMENT $16,500
- RIDA DEVELOPMENT $15,700
- ADVANCED HEALTH CARE $14,241
Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for Dan Crenshaw → · Outside spending →
Actions (2)
- Feb 10, 2025 Referred to the House Committee on Energy and Commerce. · house
- Feb 10, 2025 Introduced in House
More bills on these subjects (8)
Other bills that carry the most legislative subjects in common with this one (topical discovery — distinct from the procedural related bills above).
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Text versions (1)
Bills are re-published as they move (Introduced → Reported → Engrossed → Enrolled …). Each stage below is a separate text; pick two to see what changed. Data from Congress.gov.
Full text
IN THE HOUSE OF REPRESENTATIVES
February 10, 2025
Mr. Crenshaw (for himself, Ms. Schrier, Mr. Smucker, and Ms. Pettersen) introduced the following bill; which was referred to the Committee on Energy and Commerce
A BILL
To facilitate direct primary care arrangements under Medicaid.
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 “Medicaid Primary Care Improvement Act”.
SEC. 2. CLARIFYING THAT CERTAIN PAYMENT ARRANGEMENTS ARE ALLOWABLE UNDER THE MEDICAID PROGRAM.
(a) Rule of Construction.—Nothing in title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) shall be construed as prohibiting a State, under its State plan (or waiver of such plan) under such title (including through a medicaid managed care organization (as defined in section 1903(m)(1)(A) of such Act)), from providing medical assistance consisting of primary care services through a direct primary care arrangement with a health care provider, including as part of a value- based care arrangement established by the State. For purposes of the preceding sentence, the term “direct primary care arrangement” means, with respect to any individual, an arrangement under which such individual is provided medical assistance consisting solely of primary care services provided by primary care practitioners, if the sole compensation for such care is a fixed periodic fee.
(b) Guidance.—Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall—
(1) convene at least one virtual open door meeting to seek input from stakeholders, including primary care providers who practice under the direct primary care model, state Medicaid agencies, and Medicaid managed care organizations; and
(2) taking into account such input, issue guidance to States on how a State may implement direct primary care arrangements (as defined in subsection (a)) under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).
(c) Report.—Not later than 2 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report containing—
(1) an analysis of the extent to which States are contracting with independent physicians, independent physician practices, and primary care practices for purposes of furnishing medical assistance under State plans (or waivers of such plans) under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); and
(2) an analysis of quality of care and cost of care furnished to individuals enrolled under such title where such care is paid for under a direct primary care arrangement (as defined in subsection (a)) through a medicaid managed care organization (as so defined).
(d) Rule of Construction.—Nothing in this section shall be construed to alter statutory requirements under the State plan (or waiver of such plan) under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) for cost-sharing requirements or be construed to limit medical assistance solely to those provided under a direct primary care arrangement. <all>
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