,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #bhhd  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,april #bf1 #bjbc,mr4 
,cr5%aw 7= himself1 ,ms4 ,s*ri]1 ,mr4   
,smuck]1 & ,mr4 ,blum5au]7 introduc$ !  
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce  ,a     
,,bill  ,to facilitate direct prim>y c>e
 arrangem5ts "u ,m$icaid4  #a4 ,%ort    
title ,?is ,act may be cit$ z ! ,m$icaid
 ,prim>y ,c>e ,improvem5t ,act4  #b4    
,f9d+s ,congress f9ds z foll[s3  7#a7   
,prim>y c>e s]vices are able to r$uce   
heal?c>e co/s1 em]g5cy room visits1 &   
hospitalizations4  7#b7 ,prim>y c>e     
creates increas$ pati5t satisfaction1   
physician engagem5t1 & bett] pati5t     
outcomes4  7#c7 ,! model ( direct prim>y
 c>e c *ange pati5t usage patt]ns1 ) m  
p]sonaliz$ prev5tative c>e v]sus        
high-acuity episodic c>e4  #c4 ,cl>ify+ 
t c]ta9 paym5t arrangem5ts are all[able 
"u ! ,m$icaid program  7a7 ,9 g5]al     
,no?+ 9 title ,,xix ( ! ,social         
,security ,act 7#db ,u4,s4,c4 #acif et  

seq47 %all be con/ru$ z prohibit+ a     
,/ate1 "u its ,/ate plan 7or waiv] ( su*
 plan7 "u su* title 7includ+ ?r\gh a    
m$icaid manag$ c>e organization 7z def9$
 9 section #aijc7m7 ( su* ,act771 f     
provid+ m$ical assi/ance consi/+ (      
prim>y c>e s]vices ?r\gh a direct prim>y
 c>e arrangem5t ) a heal? c>e provid]1  
includ+ z "p ( a value-bas$ c>e         
arrangem5t e/abli%$ by ! ,/ate 7or su*  
organization74 ,= purposes ( ! prec$+   
s5t5ce1 ! t]m direct prim>y c>e         
arrangem5t means1 ) respect to any      
individual1 an arrangem5t "u :i* su*    
individual is provid$ m$ical assi/ance  
consi/+ solely ( prim>y c>e s]vices     
provid$ by prim>y c>e practition]s 7z   
def9$ 9 section #ahcc7x77#b77;,a7 ( !   
,social ,security ,act1 det]m9$ )\t     
reg>d to clause 7ii7 !re(71 if ! sole   
comp5sation = su* c>e is a fix$ p]iodic 
fee4  7b7 ,report ,n lat] ?an #a ye>    
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,heal? & ,human ,s]vices    
%all submit to ,congress a report       

conta9+ an analysis ( ! ext5t to :i*    
,/ates are contract+ ) indep5d5t        
physicians1 indep5d5t physician         
practices1 & prim>y c>e practices =     
purposes ( furni%+ m$ical assi/ance "u  
,/ate plans 7or waiv]s ( su* plans7 "u  
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq474  7c7     
,rule ( con/ruction ,no?+ 9 ?is section 
%all be con/ru$ to alt] /atutory limits 
on ,m$icaid enrollee co/-%>+ or be      
con/ru$ to limit ,m$icaid s]vices solely
 to ^? provid$ "u a direct prim>y c>e   
arrangem5t4