,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #aadj  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,febru>y #g1 #bjbe,mr4
 ,roy 7= himself1 ,mr4 ,biggs (         
,arizona1 & ,mr4 ,moore ( ,alabama7     
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means  ,a     
,,bill  ,to am5d ! ,int]nal ,rev5ue     
,code ( #aihf to all[ individuals )     
direct m$ical c>e s]vice arrangem5t to  
rema9 eligible individuals = purposes ( 
heal? sav+s acc\nts1 & = o!r purposes4  
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,direct ,m$ical ,c>e ,fre$om ,act (   
#bjbe4  #b4 ,treatm5t ( direct m$ical   
c>e s]vice arrangem5ts  7a7 ,9 g5]al    
,section #bbc7;c77#a7 ( ! ,int]nal      
,rev5ue ,code ( #aihf is am5d$ by add+  
at ! end ! foll[+ new subp>agraph3  7,e7
 ,treatm5t ( direct m$ical c>e s]vice   
arrangem5ts  7i7 ,9 g5]al ,a direct     
m$ical c>e s]vice arrangem5t %all n be  
treat$ z a heal? plan = purposes (      
subp>agraph 7,a77ii74  7ii7 ,direct     
m$ical c>e s]vice arrangem5t ,= purposes

 ( ?is p>agraph-- 7,i7 ,9 g5]al ,! t]m  
direct m$ical c>e s]vice arrangem5t     
means1 ) respect to any individual1 an  
arrangem5t "u :i* su* individual is     
provid$ m$ical c>e provid$ by m$ical c>e
 practition]s if ! sole comp5sation =   
su* c>e is a fix$ p]iodic fee4  7,,ii7  
,application to prim>y c>e1 specialty   
c>e1 etc ,an arrangem5t %all n fail to  
be treat$ z a direct m$ical c>e s]vice  
arrangem5t m]ely because su* arrangem5t 
is re/rict$ to any subset ( m$ical c>e  
or m$ical c>e practition]s4  7iii7      
,m$ical c>e practition] ,= purposes (   
?is p>agraph1 ! t]m m$ical c>e          
practition] means an individual :o is-- 
7,i7 a physician 7z def9$ 9 section     
#ahfa7r77#a7 ( ! ,social ,security      
,act71 or  7,,ii7 a nurse practition]1  
cl9ical nurse speciali/1 or physician   
assi/ant 7z su* t]ms are def9$ 9 section
 #ahfa7;aa77#e7 ( ! ,social ,security   
,act74  7iv7 ,m$ical c>e ,= purposes (  
?is p>agraph1 ! t]m m$ical c>e has !    
mean+ giv5 su* t]m 9 section #bac7;d774 

4  7b7 ,direct m$ical c>e s]vice        
arrangem5t fees treat$ z m$ical exp5ses 
,section #bbc7;d77#b77;,c7 ( su* ,code  
is am5d$ by /rik+ or at ! end ( clause  
7iii71 by /rik+ ! p]iod at ! end (      
clause 7iv7 & ins]t+ 1 or1 & by add+ at 
! end ! foll[+ new clause3  7v7 any     
direct m$ical c>e s]vice arrangem5t4  4 
7c7 ,report+ ( direct m$ical c>e s]vice 
arrangem5t fees on ,w-#b ,section       
#fjea7;a7 ( su* ,code is am5d$ by /rik+ 
& at ! end ( p>agraph 7#af71 by /rik+ ! 
p]iod at ! end ( p>agraph 7#ag7 & ins]t+
 1 &1 & by ins]t+ aft] p>agraph 7#ag7 ! 
foll[+ new p>agraph3  7#ah7 9 ! case ( a
 direct m$ical c>e s]vice arrangem5t 7z 
def9$ 9 section #bbc7;c77#a77;,e77ii77  
:i* is provid$ 9 connection ) employm5t1
 ! aggregate fees = su* arrangem5t = su*
 employee4  4  7d7 ,effective date ,!   
am5dm5ts made by ?is section %all apply 
to mon?s beg9n+ aft] ,decemb] #ca1      
#bjbd1 9 taxable ye>s end+ aft] su*     
date4