,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #cfe  ,,in ,,the ,,house ,,of   
,,representatives  ,january #f1         
#bjag,mr4 ,paulsen 7for himself1 ,mr4   
,blumenauer1 and ,mr4 ,dent7 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 #bjag4  #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 periodic fees
 paid to a primary care physician for a 
defined set of primary care medical     
services provided on an as-needed basis4
  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