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S. 4338

BillFederalSenateIn Committee
To provide for the establishment of hybrid primary care payments under the Medicare program, and for other purposes.
About This Bill
Committee
Latest Action · May 15, 2024
Read twice and referred to the Committee on Finance.
Congress
118th (2023–2025)
Introduced
May 15, 2024
Cosponsors (1)
0D 1R
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Summary

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The Pay PCPs Act of 2024 would fundamentally change how Medicare pays primary care doctors by creating a hybrid payment system that combines monthly per-patient payments with traditional fee-for-service billing. Under this new system, primary care providers could receive between 40 and 70 percent of their expected annual revenue as predictable monthly payments per patient, while the remainder would come from fee-for-service payments for other services. The legislation addresses a key problem: about 25 percent of primary care work currently goes unpaid because activities like care coordination, team-based management, and patient communication cannot be efficiently billed under current fee-for-service rules. The bill would also reduce patient cost-sharing for primary care services by 50 percent for beneficiaries who designate a primary care provider, and it establishes a 13-member technical advisory committee to study better ways to value physician services in Medicare. The legislation authorizes up to $15 million annually from 2025 through 2029 to fund the advisory committee and related research efforts.

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