,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #eege  ,,in ,,the ,,house ,,of  
,,representatives  ,january #aj1        
#bjbj,ms4 ,underwood 7for herself and   
,ms4 ,schrier7 introduced the following 
bill2 which was referred to the         
,committee on ,energy and ,commerce1 and
 in addition to the ,committees on      
,education and ,labor1 and ,ways and    
,means1 for a period to be subsequently 
determined by the ,speaker1 in each case
 for consideration of such provisions as
 fall within the jurisdiction of the    
committee concerned  ,a ,,bill  ,to     
amend the ,employee ,retirement ,income 
,security ,act of #aigd1 title ,,xxvii  
of the ,public ,health ,service ,act1   
and the ,internal ,revenue ,code of     
#aihf to require group health plans and 
health insurance issuers offering group 
or individual health insurance coverage 
to provide for #c primary care visits   
and #c behavioral health care visits    
without application of any cost-sharing 
requirement4  #a4 ,short title ,this    

,act may be cited as the ,primary and   
,behavioral ,health ,care ,access ,act  
of #bjbj4  #b4 ,prohibition on          
application of cost sharing for certain 
primary care and behavioral health care 
visits  7a7 ,,erisa ,subpart ,b of part 
#g of subtitle ,b of title ,i of the    
,employee ,retirement ,income ,security 
,act of #aigd 7#bi ,u4,s4,c4 #aahe et   
seq47 is amended by adding at the end   
the following new section3  #gaf4       
,coverage of certain primary care and   
behavioral health care visits  7a7 ,in  
general ,in addition to any item or     
service described in section #bgac7;a7  
of the ,public ,health ,service ,act1 a 
group health plan1 and a health         
insurance issuer offering group health  
insurance coverage1 shall at a minimum  
provide coverage for and shall not      
impose any cost-sharing requirements    
for1 with respect to a plan year-- 7#a7 
#c primary care visits2 and  7#b7 #c    
behavioral health care visits4  7b7     
,limitations ,a group health plan1 and a

 health insurance issuer offering group 
health insurance coverage1 shall ensure 
that--  7#a7 the treatment limitations  
applicable to the #c primary care visits
 described in paragraph 7#a7 of         
subsection 7a7 and the #c behavioral    
health care visits described in         
paragraph 7#b7 of such subsection are no
 more restrictive than the treatment    
limitations applied to any other primary
 care visit or behavioral health care   
visit covered by the plan or coverage   
and that there are no separate treatment
 limitations that are applicable only   
with respect to such #c primary or such 
#c behavioral health care visits2 and   
7#b7 the reimbursement rates under such 
plan or such coverage for such #c       
primary and such #c behavioral health   
care visits are the same as such rates  
for any other primary care visit or     
behavioral health care visit covered by 
the plan or coverage4  7c7 ,definitions 
,for purposes of this section3 7#a7     
,behavioral health care visit ,the term 

behavioral health care visit means a    
visit by an individual to a qualified   
provider during which services are      
provided with respect to the diagnosis1 
treatment1 screening1 or prevention of a
 behavioral health condition4  7#b7     
,primary care service ,the term primary 
care service means a service identified1
 as of ,january #a1 #bjji1 by one of    
,,hcpcs codes #iibja through #iibae 7and
 as subsequently modified by the        
,secretary74  7#c7 ,primary care visit  
,the term primary care visit means an   
in-person visit by an individual to a   
qualified provider who is designated by 
such individual as the primary care     
provider for such individual1 during    
which such individual receives primary  
care services4  7#d7 ,qualified provider
 ,the term qualified provider means--   
7,a7 with respect to a primary care     
visit1 a general practitioner1 family   
physician1 general internist1           
obstetrician-gynecologist1 pediatrician1
 geriatric physician1 or advanced       

practice registered nurse acting in     
accordance with ,state law 7including a 
nurse practitioner1 clinical nurse      
specialist1 and certified nurse         
midwife72 and  7,b7 with respect to a   
behavioral health care visit1 an        
individual employed in a full-time      
position 7including a fellowship7 where 
the primary intent and function of such 
position is the direct treatment or     
recovery support of individuals with1 or
 in recovery from1 a behavioral health  
disorder1 such as a physician1 advanced 
practice registered nurse acting in     
accordance with ,state law 7including a 
nurse practitioner1 clinical nurse      
specialist1 and certified nurse         
midwife71 psychiatric nurse1 social     
worker1 marriage and family therapist1  
mental health counselor1 occupational   
therapist1 psychologist1 psychiatrist1  
child and adolescent psychiatrist1 or   
neurologist4  4  7b7 ,,phsa ,subpart    
,,ii of part ,a of title ,,xxvii of the 
,public ,health ,service ,act 7#db      

,u4,s4,c4 #cjj;gg-#aa et seq47 is       
amended by adding at the end the        
following new section3  #bgcj4 ,coverage
 of certain primary care and behavioral 
health care visits  7a7 ,in general ,in 
addition to any item or service         
described in section #bgac7;a71 a group 
health plan1 and a health insurance     
issuer offering group or individual     
health insurance coverage1 shall at a   
minimum provide coverage for and shall  
not impose any cost-sharing requirements
 for1 with respect to a plan year-- 7#a7
 #c primary care visits2 and  7#b7 #c   
behavioral health care visits4  7b7     
,limitations ,a group health plan1 and a
 health insurance issuer offering group 
or individual health insurance coverage1
 shall ensure that--  7#a7 the treatment
 limitations applicable to the #c       
primary care visits described in        
paragraph 7#a7 of subsection 7a7 and the
 #c behavioral health care visits       
described in paragraph 7#b7 of such     
subsection are no more restrictive than 

the treatment limitations applied to any
 other primary care visit or behavioral 
health care visit covered by the plan or
 coverage and that there are no separate
 treatment limitations that are         
applicable only with respect to such #c 
primary or such #c behavioral health    
care visits2 and  7#b7 the reimbursement
 rates under such plan or such coverage 
for such #c primary and such #c         
behavioral health care visits are the   
same as such rates for any other primary
 care visit or behavioral health care   
visit covered by the plan or coverage4  
7c7 ,definitions ,for purposes of this  
section3 7#a7 ,behavioral health care   
visit ,the term behavioral health care  
visit means a visit by an individual to 
a qualified provider during which       
services are provided with respect to   
the diagnosis1 treatment1 screening1 or 
prevention of a behavioral health       
condition4  7#b7 ,primary care service  
,the term primary care service means a  
service identified1 as of ,january #a1  

#bjji1 by one of ,,hcpcs codes #iibja   
through #iibae 7and as subsequently     
modified by the ,secretary74  7#c7      
,primary care visit ,the term primary   
care visit means an in-person visit by  
an individual to a qualified provider   
who is designated by such individual as 
the primary care provider for such      
individual1 during which such individual
 receives primary care services4  7#d7  
,qualified provider ,the term qualified 
provider means-- 7,a7 with respect to a 
primary care visit1 a general           
practitioner1 family physician1 general 
internist1 obstetrician-gynecologist1   
pediatrician1 geriatric physician1 or   
advanced practice registered nurse      
acting in accordance with ,state law    
7including a nurse practitioner1        
clinical nurse specialist1 and certified
 nurse midwife72 and  7,b7 with respect 
to a behavioral health care visit1 an   
individual employed in a full-time      
position 7including a fellowship7 where 
the primary intent and function of such 

position is the direct treatment or     
recovery support of individuals with1 or
 in recovery from1 a behavioral health  
disorder1 such as a physician1 advanced 
practice registered nurse acting in     
accordance with ,state law 7including a 
nurse practitioner1 clinical nurse      
specialist1 and certified nurse         
midwife71 psychiatric nurse1 social     
worker1 marriage and family therapist1  
mental health counselor1 occupational   
therapist1 psychologist1 psychiatrist1  
child and adolescent psychiatrist1 or   
neurologist4  4  7c7 ,,irc  7#a7 ,in    
general ,subchapter ,b of chapter #ajj  
of subtitle ,k of the ,internal ,revenue
 ,code of #aihf is amended by adding at 
the end the following new section3      
#ihaf4 ,coverage of certain primary care
 and behavioral health care visits  7a7 
,in general ,in addition to any item or 
service described in section #bgac7;a7  
of the ,public ,health ,service ,act1 a 
group health plan shall at a minimum    
provide coverage for and shall not      

impose any cost-sharing requirements    
for1 with respect to a plan year-- 7#a7 
#c primary care visits2 and  7#b7 #c    
behavioral health care visits4  7b7     
,limitations ,a group health plan shall 
ensure that--  7#a7 the treatment       
limitations applicable to the #c primary
 care visits described in paragraph 7#a7
 of subsection 7a7 and the #c behavioral
 health care visits described in        
paragraph 7#b7 of such subsection are no
 more restrictive than the treatment    
limitations applied to any other primary
 care visit or behavioral health care   
visit covered by the plan and that there
 are no separate treatment limitations  
that are applicable only with respect to
 such #c primary or such #c behavioral  
health care visits2 and  7#b7 the       
reimbursement rates under such plan for 
such #c primary and such #c behavioral  
health care visits are the same as such 
rates for any other primary care visit  
or behavioral health care visit covered 
by the plan4  7c7 ,definitions ,for     

purposes of this section3 7#a7          
,behavioral health care visit ,the term 
behavioral health care visit means a    
visit by an individual to a qualified   
provider during which services are      
provided with respect to the diagnosis1 
treatment1 screening1 or prevention of a
 behavioral health condition4  7#b7     
,primary care service ,the term primary 
care service means a service identified1
 as of ,january #a1 #bjji1 by one of    
,,hcpcs codes #iibja through #iibae 7and
 as subsequently modified by the        
,secretary74  7#c7 ,primary care visit  
,the term primary care visit means an   
in-person visit by an individual to a   
qualified provider who is designated by 
such individual as the primary care     
provider for such individual1 during    
which such individual receives primary  
care services4  7#d7 ,qualified provider
 ,the term qualified provider means--   
7,a7 with respect to a primary care     
visit1 a general practitioner1 family   
physician1 general internist1           

obstetrician-gynecologist1 pediatrician1
 geriatric physician1 or advanced       
practice registered nurse acting in     
accordance with ,state law 7including a 
nurse practitioner1 clinical nurse      
specialist1 and certified nurse         
midwife72 and  7,b7 with respect to a   
behavioral health care visit1 an        
individual employed in a full-time      
position 7including a fellowship7 where 
the primary intent and function of such 
position is the direct treatment or     
recovery support of individuals with1 or
 in recovery from1 a behavioral health  
disorder1 such as a physician1 advanced 
practice registered nurse acting in     
accordance with ,state law 7including a 
nurse practitioner1 clinical nurse      
specialist1 and certified nurse         
midwife71 psychiatric nurse1 social     
worker1 marriage and family therapist1  
mental health counselor1 occupational   
therapist1 psychologist1 psychiatrist1  
child and adolescent psychiatrist1 or   
neurologist4  4  7#b7 ,high deductible  

health plans ,section #bbc7;c77#b77;,c7 
of the ,internal ,revenue ,code of #aihf
 is amended by inserting or for the     
visits described in section #ihaf before
 the period4  7d7 ,effective date ,the  
amendments made by this section shall   
apply with respect to plan years        
beginning on or after the date that is  
#b years after the date of the enactment
 of this ,act4