“A bill to facilitate direct primary care arrangements under Medicaid.”
No CRS summary available for this bill.
This section clarifies that states may provide Medicaid primary care services through direct primary care arrangements (i.e., fixed periodic fee paid to primary care practitioners for such services only), including via Medicaid managed care organizations or state-established value-based care arrangements. It further (1) defines relevant terms; (2) directs the Secretary of Health and Human Services, within one year of enactment, to convene at least one virtual open-door stakeholder meeting (including primary care providers, state Medicaid agencies, and managed care organizations) and issue related implementation guidance to states; (3) requires the Secretary, within two years of enactment, to report to Congress analyzing states' use of such arrangements with independent physicians or practices and their impacts on care quality and costs when paid through managed care organizations; and (4) specifies that the provision does not alter other Medicaid requirements on cost-sharing or the amount, duration, and scope of covered services.