,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #cfe  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,janu>y #f1 #bjag,mr4 
,pauls5 7= himself1 ,mr4 ,blum5au]1 &   
,mr4 ,d5t7 introduc$ ! foll[+ bill2 :i* 
0 ref]r$ to ! ,committee on ,ways &     
,means  ,a ,,bill  ,to am5d ! ,int]nal  
,rev5ue ,code ( #aihf to provide = !    
treatm5t ( c]ta9 direct prim>y c>e      
s]vice arrangem5ts & p]iodic provid]    
fees4  #a4 ,%ort title ,?is ,act may be 
cit$ z ! ,prim>y ,c>e ,enhancem5t ,act (
 #bjag4  #b4 ,treatm5t ( direct prim>y  
c>e s]vice arrangem5ts  7a7 ,9 g5]al    
,section #bbc7;c7 ( ! ,int]nal ,rev5ue  
,code ( #aihf is am5d$ by add+ at ! end 
! foll[+ new p>agraph3  7#f7 ,treatm5t (
 direct prim>y c>e s]vice arrangem5ts   
,an arrangem5t "u :i* an individual is  
provid$ cov]age re/rict$ to prim>y c>e  
s]vices 9 ex*ange = a fix$ p]iodic fee  
or paym5t = su* s]vices--  7,a7 %all n  
be treat$ z a heal? plan = purposes (   
p>agraph 7#a77;,a77ii71 &  7,b7 %all n  
be treat$ z insurance = purposes (      

subsection 7d77#b77;,b74  4  7b7        
,effective date ,! am5dm5t made by ?is  
section %all apply to taxable ye>s      
beg9n+ aft] ! date ( ! enactm5t ( ?is   
,act4  #c4 ,c]ta9 provid] fees to be    
treat$ z m$ical c>e  7a7 ,9 g5]al       
,section #bac7;d7 ( ! ,int]nal ,rev5ue  
,code ( #aihf is am5d$ by add+ at ! end 
! foll[+ new p>agraph3  7#ab7 ,p]iodic  
provid] fees ,! t]m m$ical c>e %all     
include p]iodic fees paid to a prim>y   
c>e physician = a def9$ set ( prim>y c>e
 m$ical s]vices provid$ on an z-ne$$    
basis4  4  7b7 ,effective date ,!       
am5dm5t made by ?is section %all apply  
to taxable ye>s beg9n+ aft] ! date ( !  
enactm5t ( ?is ,act4