The Academy is encouraging recently introduced legislation that could tear down a key obstacle to broader adoption of the direct primary care model.
The Primary Care Enhancement Act of 2019 (H.R. 3708)(www.congress.gov) would revise the federal tax code to allow patients with health savings accounts to apply that resource toward DPC payments.
That's a significant step forward for the DPC model, the AAFP told Reps. Earl Blumenauer, D-Ore., and Jason Smith, R-Mo., in an Aug. 12 letter(1 page PDF) praising their bill.
"The AAFP supports direct primary care and sees it as a model of care that provides a pathway to continuous, comprehensive and coordinated primary care for patients," said the letter, which was signed by Board Chair Michael Munger, M.D., of Overland Park.
But regulators treat DPC payments as health insurance premiums, so DPC patients can't use HSAs to pay their monthly fees without incurring a tax penalty.
"Under existing interpretation of the Internal Revenue Code, patients with HSAs are prohibited from engaging in DPC arrangements with a family physician or other primary-care physician," the Academy wrote. "Your legislation would remove these current legal barriers that prevent patients with HSAs from receiving care from family physicians practicing in a DPC model."
The Academy reminded the congressmen that the DPC model is attracting a growing number of family physicians, with patient demand for such practices also on the rise.
"Additionally, employers and labor unions(www.commonwealthfund.org) are driving growth in the model, further necessitating changes in law that allow patients to benefit from this emerging primary care delivery model," the letter noted.
The Academy supported a similar bill in 2017.
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