119-HR1140

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House Senate President

119th CONGRESS

1st Session

H. R. 1140

1. Short title
2. Treatment of direct medical care service arrangements

1. Short title

This Act may be cited as the "Direct Medical Care Freedom Act of 2025".

2. Treatment of direct medical care service arrangements

(a) In general - Section 223(c)(1) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph:

(E) Treatment of direct medical care service arrangements

(i) In general - A direct medical care service arrangement shall not be treated as a health plan for purposes of subparagraph (A)(ii).

(ii) Direct medical care service arrangement - For purposes of this paragraph—

(I) In general - 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.

(II) Application to primary care, specialty care, etc - 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.

(iii) Medical care practitioner - For 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 care - For purposes of this paragraph, the term "medical care" has the meaning given such term in section 213(d)).

(b) Direct medical care service arrangement fees treated as medical expenses - 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:

(v) - any direct medical care service arrangement.

(c) Reporting of direct medical care service arrangement fees on W–2 - 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:

(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.

(d) Effective date - The amendments made by this section shall apply to months beginning after December 31, 2024, in taxable years ending after such date.