HR1140-119

2. Treatment of direct medical care service arrangements Section 223(c)(1) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph: A direct medical care service arrangement shall not be treated as a health plan for purposes of subparagraph (A)(ii). For purposes of this paragraph— The term direct medical care service arrangement means, with respect to any individual, an arrangement under which such individual is provided medical care provided by medical care practitioners if the sole compensation for such care is a fixed periodic fee. An arrangement shall not fail to be treated as a direct medical care service arrangement merely because such arrangement is restricted to any subset of medical care or medical care practitioners. For purposes of this paragraph, the term medical care practitioner means an individual who is— a physician (as defined in section 1861(r)(1) of the Social Security Act), or a nurse practitioner, clinical nurse specialist, or physician assistant (as such terms are defined in section 1861(aa)(5) of the Social Security Act). For purposes of this paragraph, the term medical care has the meaning given such term in section 213(d)). Section 223(d)(2)(C) of such Code is amended by striking or at the end of clause (iii), by striking the period at the end of clause (iv) and inserting , or, and by adding at the end the following new clause: any direct medical care service arrangement. Section 6051(a) of such Code is amended by striking and at the end of paragraph (16), by striking the period at the end of paragraph (17) and inserting , and, and by inserting after paragraph (17) the following new paragraph: in the case of a direct medical care service arrangement (as defined in section 223(c)(1)(E)(ii)) which is provided in connection with employment, the aggregate fees for such arrangement for such employee. The amendments made by this section shall apply to months beginning after December 31, 2024, in taxable years ending after such date. (E)Treatment of direct medical care service arrangements(i)In generalA direct medical care service arrangement shall not be treated as a health plan for purposes of subparagraph (A)(ii).(ii)Direct medical care service arrangementFor purposes of this paragraph—(I)In generalThe term direct medical care service arrangement means, with respect to any individual, an arrangement under which such individual is provided medical care provided by medical care practitioners if the sole compensation for such care is a fixed periodic fee. (II)Application to primary care, specialty care, etcAn arrangement shall not fail to be treated as a direct medical care service arrangement merely because such arrangement is restricted to any subset of medical care or medical care practitioners.(iii)Medical care practitionerFor purposes of this paragraph, the term medical care practitioner means an individual who is—(I)a physician (as defined in section 1861(r)(1) of the Social Security Act), or(II)a nurse practitioner, clinical nurse specialist, or physician assistant (as such terms are defined in section 1861(aa)(5) of the Social Security Act).(iv)Medical careFor purposes of this paragraph, the term medical care has the meaning given such term in section 213(d)).. (v)any direct medical care service arrangement.. (18)in the case of a direct medical care service arrangement (as defined in section 223(c)(1)(E)(ii)) which is provided in connection with employment, the aggregate fees for such arrangement for such employee..