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To facilitate direct primary care arrangements under Medicaid.
2/11/2025, 9:05 AM
Summary of Bill HR 1162
Bill 119 HR 1162, also known as the "Direct Primary Care Enhancement Act," aims to make it easier for Medicaid recipients to access direct primary care services. Direct primary care is a healthcare model in which patients pay a monthly fee to a primary care provider in exchange for unlimited access to basic medical services.
The bill seeks to clarify that direct primary care arrangements are not considered insurance under Medicaid, which would allow Medicaid recipients to use their benefits to pay for these services. This would make it more affordable for low-income individuals to access primary care services on a regular basis, potentially improving health outcomes and reducing overall healthcare costs.
The bill has received bipartisan support in Congress, with proponents arguing that it could help address the shortage of primary care providers in underserved communities and improve access to healthcare for Medicaid recipients. Critics, however, have raised concerns about the potential impact on traditional insurance models and the quality of care provided under direct primary care arrangements. Overall, Bill 119 HR 1162 aims to expand access to primary care services for Medicaid recipients through direct primary care arrangements, potentially improving health outcomes and reducing healthcare costs for low-income individuals.
The bill seeks to clarify that direct primary care arrangements are not considered insurance under Medicaid, which would allow Medicaid recipients to use their benefits to pay for these services. This would make it more affordable for low-income individuals to access primary care services on a regular basis, potentially improving health outcomes and reducing overall healthcare costs.
The bill has received bipartisan support in Congress, with proponents arguing that it could help address the shortage of primary care providers in underserved communities and improve access to healthcare for Medicaid recipients. Critics, however, have raised concerns about the potential impact on traditional insurance models and the quality of care provided under direct primary care arrangements. Overall, Bill 119 HR 1162 aims to expand access to primary care services for Medicaid recipients through direct primary care arrangements, potentially improving health outcomes and reducing healthcare costs for low-income individuals.
Congressional Summary of HR 1162
Medicaid Primary Care Improvement Act
This bill specifies that state Medicaid programs are authorized to provide primary care services through direct primary care arrangements (i.e., arrangements in which primary care providers receive a fixed periodic fee for their services).
The Centers for Medicare & Medicaid Services must (1) convene at least one virtual stakeholder meeting and issue related guidance on how state Medicaid programs may implement direct primary care arrangements, and (2) report on the extent to which state Medicaid programs contract with independent providers and on the quality and cost of care under direct primary care arrangements that are offered through Medicaid managed care organizations.
Current Status of Bill HR 1162
Bill HR 1162 is currently in the status of Bill Introduced since February 10, 2025. Bill HR 1162 was introduced during Congress 119 and was introduced to the House on February 10, 2025. Bill HR 1162's most recent activity was Referred to the House Committee on Energy and Commerce. as of February 10, 2025
Bipartisan Support of Bill HR 1162
Total Number of Sponsors
1Democrat Sponsors
0Republican Sponsors
1Unaffiliated Sponsors
0Total Number of Cosponsors
3Democrat Cosponsors
2Republican Cosponsors
1Unaffiliated Cosponsors
0Policy Area and Potential Impact of Bill HR 1162
Primary Policy Focus
Alternate Title(s) of Bill HR 1162
To facilitate direct primary care arrangements under Medicaid.
To facilitate direct primary care arrangements under Medicaid.
Comments
Sponsors and Cosponsors of HR 1162
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