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S. 1989 (114th): Primary Care Enhancement Act of 2015


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The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Aug 5, 2015.


Primary Care Enhancement Act of 2015

This bill amends the Internal Revenue Code to: (1) permit an individual to pay primary care service arrangement costs from a health savings account; (2) allow an eligible taxpayer enrolled in a high-deductible health plan to take a tax deduction for cash paid into a health savings account, even if the taxpayer is simultaneously enrolled in a primary care service arrangement; and (3) for purposes of certain tax-deductible expenses for medical care, expand the definition of "medical care" to include periodic provider fees. A "primary care service arrangement" is an exchange of ongoing primary care services for a fixed periodic fee which is not billed to any third party on a fee-for-service basis.

The bill also amends title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation (CMI) to test a primary care medical home model for payment and service delivery. Under this type of model, qualified direct primary care medical home practices are reimbursed a periodic fee for serving Medicare enrollees. In selecting qualified direct primary care medical home practices to participate, CMI shall give priority to practices seeking to enroll dual-eligible individuals.

CMI must conduct the model for at least three years, but, if specified conditions are met, CMI shall expand the model on a nationwide basis and a participating practice may continue permanently.