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DPC Physician meets with Senators and Congressman on HR6199

Dr. James Pinckney II, ABFM of Diamond Physicians met with eight senators and two congressmen last week in an effort to reintroduce the Direct Primary Care Bill HR6199.

To further demonstrate the effectiveness of direct primary care, Michael Schneider, CEO of A-1 Locksmith DFW, accompanied the team. Together, they presented how a small blue-collar business was able to save 25% on their health benefits as a company while improving the care and health of their employees.

As this process progresses, it’s becoming increasingly likely that direct primary care membership will become a qualified medical expense under 213-D via executive order. This would allow for the bill to bypass congressional approval.

Upon passage, the bill would allow consumers to use HSA cards to pay for direct primary care membership.

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An easy, free way to lower health-care costs for millions of Americans

In October, the Trump administration proposed a new rule that would expand the ways employers can use health reimbursement arrangements (HRAs) to provide their employees with high-quality, low-cost health coverage. The United States Department of the Treasury estimates that once the new rules go into effect, 800,000 employers will take advantage of HRAs, which could affect coverage for more than 10 million employees.

HRAs are employer-funded accounts used to augment group health plans. Contributions made to HRA accounts are not taxed. Under Obama-era rules, HRAs can be used by employees to pay for qualifying health expenses, as determined by federal regulations and employers, in conjunction with a group health insurance plan.

HRAs can, for example, be used by people to cover out-of-pocket costs for a medical procedure. Funds that remain in an HRA account at the end of each year can be rolled over to the following year, encouraging health care savings.

Although HRAs currently offer some employees and their family members important benefits, they have been limited dramatically by federal agencies — a problem the Trump administration is now working to solve.

The administration could improve its proposed rule by clarifying that patients who pay for direct primary care (DPC) agreements would be eligible for reimbursement through their employer’s HRA. By classifying DPCs as a qualifying health-care expense, employees could use their HRAs to pay DPC costs, making it easier than ever for them to have access to more affordable primary care services.

DPCs are fixed-fee agreements made directly between primary care doctors and patients. Direct primary care agreements offer patients access to a defined set of health care services, including chronic disease treatment, check-ups and various health tests, at a flat, fixed monthly rate. At Epiphany Health, the direct primary care practice I founded in North Port, Fla., we charge only $65 per month for an adult membership and $25 for one child. A four-person family pays just $155 per month to receive primary care services, as well as have access to other typically more expensive care, like MRIs or blood tests, at a steeply discounted rate.

As the Docs 4 Patient Care Foundation, an organization I serve as president, noted in our substantive, eight-page comment invited by the administration, allowing the millions of people expected to access HRAs in the coming years to use these funds to pay for DPC agreements would be one of the most important improvements the Trump administration could make to the proposed rule. This would not only save money for millions of people, it would also reduce health care costs across the board and encourage those with HRAs to access routine care, save money and build up the funds in their HRA accounts.

Read the full article at The Hill.

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D4PCF Asks Trump Administration for Tax Protection of Direct Primary Care Members and Their Employers

An 8-page legal letter asks multiple federal departments to recognize DPC membership dues as tax-free medical expenses

WASHINGTON, January 4, 2019 — Last week the Internal Revenue Service (IRS) received an official request from the Docs 4 Patient Care Foundation (D4PCF) to recognize dues paid to direct primary care (DPC) practices as tax-free medical expenses reimbursable by employers.

Multiple federal departments ought to clarify “that the monthly fees associated with DPCs are qualified medical expenses which can be offset by HRA funds,” states the eight-page letter, which has 31 footnotes citing federal regulations and court cases.

DPC membership is not a form of insurance, so dues are a legitimate medical expense, D4PCF argues. Consequently, patients should be allowed to submit their monthly membership costs—which range from $40 to $150 per person—to their employers for tax-free reimbursement, if their employers offer health reimbursement accounts (HRAs).

The Trump administration appears amenable to the viewpoint that tax protection for DPC patients is long overdue, according to a statement made by D4PCF Board President Dr. Lee Gross upon filing the letter:

“The direct primary care community has spent many years frustrated by the lack of progress in fixing the HSA issue that has hamstrung the DPC movement for so long. D4PCF recognized an opportunity to advance this initiative through our multiple meetings with the executive branch, while also working through our legislative priorities.

“D4PCF engaged the Washington, D.C. law firm of Foley Hoag to draft a legal basis for allowing HRAs to be used for DPC memberships. This legal argument was submitted as a formal comment to the Departments of Health and Human Services, Treasury and Labor during the public comment period for the proposed rule for overhauling the use of HRAs across the country.

“We look forward to continuing to work with the Trump administration and Congress to expand access to this affordable care model for all Americans.”

D4PCF filed its letter as a comment on the proposed rule “Health Reimbursement Arrangements and Other Account-Based Group Health Plans” (REG-136724-17).

In November of 2018, Gross testified to the U.S. Senate Health, Education, Labor and Pensions Committee that removing barriers to DPC membership would immediately achieve multibillion-dollar savings for patients and taxpayers.

Docs 4 Patient Care Foundation is the only 501(c)(3) public policy think tank governed exclusively by doctors standing up for the health and freedom of patients and physicians. The D4PCF mission is to preserve the sanctity of the physician-patient relationship, promote quality care, support affordable access to care for all Americans, and protect the patient’s personal health care decisions.

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Direct primary care can rein in America’s out-of-control healthcare costs

By: Dr. Lee Gross

While Democrats and Republicans debate the merits and drawbacks of reforming America’s broken health insurance system, few policymakers are paying attention to perhaps the biggest reason health insurance is so expensive: The actual cost of healthcare, which insurers have to pay, is out of control.

There are many reasons the cost of providing healthcare has been steadily rising in most sectors of the healthcare industry. One of the most important is that the traditional health insurance model wastes piles of cash. It pays health insurers to act as middlemen between patients and their doctors. Patients continue to use their health insurance to pay for virtually every healthcare service, including those that they could easily pay for on their own, like primary care visits, flu shots, and routine exams.

Insurers’ involvement in nearly every primary care visit is causing healthcare expenses to skyrocket. Patients are being forced to pay extra so insurance companies can facilitate transactions they really don’t need to be involved in. Not only does this cause the cost of primary care services to rise, it also forces doctors to squander time filling out paperwork instead of treating patients. Some doctors choose to hire more staff to handle much of the administrative work, also contributing to the rising cost of providing primary care.

As I recently noted in testimony before the U.S. Senate Committee on Health, Education, Labor, and Pensions, “We don’t expect our homeowner’s insurance to pay for blown light bulbs or routine maintenance. Imagine how complex and expensive it would be to purchase gasoline if we used our auto insurance to pay for fuel. This is what we expect from our health insurance, yet we are surprised that it is expensive, inefficient, and impersonal.”

Fortunately, there is a better way to provide primary care, one that offers high-quality healthcare services for much less money and without inflicting mountains of complicated insurance paperwork and government regulations on doctors.

Direct primary care is a membership-based primary care model that provides patients with a set number of healthcare services in exchange for a flat monthly fee. At Epiphany Health, the direct primary care practice I founded in North Port, Fla., we charge just $65 per month for an adult membership and $25 for one child. (A membership for each additional child is just $10.) A family of four pays only $155 per month.

In exchange for that fee, we offer all of our members the primary care services they need most often, including physical exams, EKG testing, strep and urine testing, blood-thinner monitoring, minor surgical procedures, joint injections, and much more. Patients don’t pay a single penny more for these services beyond the cost of their membership fee.

Read the full op-ed at the Washington Examiner.

 

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D4PCF on Hannity National Radio

The National Briefing on Health Care Policy Begins

The frustration over health care policy at the Federal level has moved national radio host Sean Hannity to launch the national discussion with the doctor innovators on the front lines of health care.

Dr. Josh Umbehr and our own Dr. Lee Gross joined Hannity on his national radio show to kick off a regular Tuesday afternoon national briefing on the impact of free market medicine.

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