,i  #aadth ,,congress  #b;d ,session    
,h4 ,r4 #fjae  ,,in ,,the ,,house ,,of  
,,representatives  ,september #ac1      
#bjaf,mr4 ,paulsen 7for himself and ,mr4
 ,blumenauer7 introduced the following  
bill2 which was referred to the         
,committee on ,ways and ,means  ,a      
,,bill  ,to amend the ,internal ,revenue
 ,code of #aihf to provide for the      
treatment of certain direct primary care
 service arrangements and periodic      
provider fees4  #a4 ,short title ,this  
,act may be cited as the ,primary ,care 
,enhancement ,act of #bjaf4  #b4        
,treatment of direct primary care       
service arrangements  7a7 ,in general   
,section #bbc7;c7 of the ,internal      
,revenue ,code of #aihf is amended by   
adding at the end the following new     
paragraph3  7#f7 ,treatment of direct   
primary care service arrangements ,an   
arrangement under which an individual is
 provided coverage restricted to primary
 care services in exchange for a fixed  
periodic fee or payment for such        

services--  7,a7 shall not be treated as
 a health plan for purposes of paragraph
 7#a77;,a77ii71 and  7,b7 shall not be  
treated as insurance for purposes of    
subsection 7d77#b77;,b74  4  7b7        
,effective date ,the amendment made by  
this section shall apply to taxable     
years beginning after the date of the   
enactment of this ,act4  #c4 ,certain   
provider fees to be treated as medical  
care  7a7 ,in general ,section #bac7;d7 
of the ,internal ,revenue ,code of #aihf
 is amended by adding at the end the    
following new paragraph3  7#ab7         
,periodic provider fees ,the term       
medical care shall include-- 7,a7       
periodic fees paid to a primary care    
physician for a defined set of medical  
services or the right to receive medical
 services on an as-needed basis1 and    
7,b7 pre-paid primary care services     
designed to screen for1 diagnose1 cure1 
mitigate1 treat1 or prevent disease and 
promote wellness4  4  7b7 ,effective    
date ,the amendment made by this section

 shall apply to taxable years beginning 
after the date of the enactment of this 
,act4