,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #cdcf  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,may #bj1 #bjba,mr4   
,ros5dale introduc$ ! foll[+ bill2 :i* 0
 ref]r$ to ! ,committee on ,en]gy &     
,comm]ce  ,a ,,bill  ,to am5d title     
,,xxvii ( ! ,public ,heal? ,s]vice ,act 
to exempt c]ta9 direct prim>y c>e       
arrangem5ts f regulation z heal?        
insurance cov]age4  #a4 ,%ort title ,?is
 ,act may be cit$ z ! ,direct ,prim>y   
,c>e ,accessibility ,act ( #bjba4  #b4  
,exempt+ c]ta9 direct prim>y c>e        
arrangem5ts f regulation z heal?        
insurance cov]age ,section #bgia7;b7 ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #cjj;gg-#ia7;b77 is am5d$--   
7#a7 9 p>agraph 7#a71 by ins]t+ 1 except
 t su* t]m %all n include a direct      
prim>y c>e arrangem5t 7z def9$ 9        
p>agraph 7#f77 be=e ! p]iod2 &  7#b7 by 
add+ at ! end ! foll[+ new p>agraph3    
7#f7 ,direct prim>y c>e arrangem5t  7,a7
 ,9 g5]al ,except z provid$ 9           
subp>agraph 7,b71 ! t]m direct prim>y   

c>e arrangem5t means an arrangem5t "u   
:i* an item or s]vice is furni%$ by a   
heal? c>e provid] to an individual 9    
return = a direct fee4 ,su* a fee may   
include-- 7i7 a mon?ly reta9]2  7ii7 a  
memb]%ip fee2  7iii7 a subscription fee2
 or  7iv7 a fee = a s]vice1 visit1 or   
episode ( c>e4  7,b7 ,exception ,! t]m  
direct prim>y c>e arrangem5t %all n     
include any arrangem5t unless-- 7i7 a   
copy ( su* arrangem5t is provid$ to !   
individual ent]+ into su* agreem5t 7or !
 legal repres5tative ( su* individual72 
&  7ii7 su* agreem5t-- 7,i7 is 9 writ+2 
7,,ii7 describes ! items & s]vices to be
 provid$ 9 ex*ange = paym5t ( a direct  
fee 7z describ$ 9 subp>agraph 7,a772    
7,,iii7 specifies ! direct fee requir$ &
 any additional fees to be paid by a    
?ird p>ty2  7,,iv7 specifies !          
individual's paym5t obligation2 &  7,v7 
prohibits ! provid] f *>g+ or receiv+   
additional comp5sation = items & s]vices
 includ$ 9 ! direct fee4  4