,,ii  #aaith ,,congress  #ast ,session  
,s4 #cbih  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #b1  
#bjbe,mrs4 ,blackburn introduced the    
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to facilitate direct primary
 care arrangements under ,medicaid4  #a4
 ,short title ,this ,act may be cited as
 the ,medicaid ,primary ,care           
,improvement ,act4  #b4 ,clarifying that
 certain payment arrangements are       
allowable under the ,medicaid program   
7a7 ,in general ,nothing in title ,,xix 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acif et seq47 shall be       
construed as prohibiting a ,state1 under
 its ,state plan 7or waiver of such     
plan7 under such title 7including       
through a medicaid managed care         
organization71 from providing medical   
assistance consisting of primary care   
services through a direct primary care  
arrangement with a health care provider1
 including as part of a value-based care

 arrangement established by the ,state4 
7b7 ,definitions ,in this ,act3 7#a7    
,direct primary care arrangement ,the   
term direct primary care arrangement    
means1 with respect to any individual1  
an arrangement under which such         
individual is provided medical          
assistance consisting solely of primary 
care services provided by primary care  
practitioners1 if the sole compensation 
for such care is a fixed periodic fee4  
7#b7 ,medicaid managed care organization
 ,the term medicaid managed care        
organization has the meaning given that 
term in section #aijc7m77#a77;,a7 of the
 ,social ,security ,act 7#db ,u4,s4,c4  
#acif;b7m77#a77;,a774  7#c7 ,secretary  
,the term ,secretary means the          
,secretary of ,health and ,human        
,services4  7c7 ,guidance ,not later    
than #a year after the date of enactment
 of this ,act1 the ,secretary shall--   
7#a7 convene at least #a virtual open   
door meeting to seek input from         
stakeholders1 including primary care    

providers who practice under the direct 
primary care model1 ,state ,medicaid    
agencies1 and medicaid managed care     
organizations2 and  7#b7 taking into    
account such input1 issue guidance to   
,states on how a ,state may implement   
direct primary care arrangements under  
title ,,xix of the ,social ,security    
,act 7#db ,u4,s4,c4 #acif et seq474  7d7
 ,report ,not later than #b years after 
the date of enactment of this ,act1 the 
,secretary shall submit to ,congress a  
report containing-- 7#a7 an analysis of 
the extent to which ,states are         
contracting with independent physicians1
 independent physician practices1 and   
primary care practices for purposes of  
furnishing medical assistance under     
,state plans 7or waivers of such plans7 
under title ,,xix of the ,social        
,security ,act 7#db ,u4,s4,c4 #acif et  
seq47 through direct primary care       
arrangements2 and  7#b7 an analysis of  
quality of care and cost of care        
furnished to individuals enrolled under 

such title where such care is paid for  
under a direct primary care arrangement 
through a medicaid managed care         
organization4  7e7 ,rule of construction
 ,nothing in this section shall be      
construed to alter statutory            
requirements applicable to ,state plans 
7or waivers of such plans7 under title  
,,xix of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acif et seq471 including    
requirements relating to cost-sharing   
and requirements relating to the amount1
 duration1 and scope of medical         
assistance that is required to be made  
available to individuals who are        
eligible for such assistance under such 
a plan or waiver4