S. 3298 clarifies that states can use "direct primary care" arrangements to deliver Medicaid benefits, where patients pay doctors a fixed monthly or periodic fee in exchange for primary care services, rather than using traditional fee-for-service or insurance billing. The bill allows states to implement this model independently or through Medicaid managed care organizations as part of value-based care programs. Within one year of enactment, the Department of Health and Human Services must hold stakeholder meetings and issue guidance to states on how to set up these arrangements, and within two years must report to Congress on how many states are using direct primary care contracts and whether this model affects quality and costs of care. The legislation does not change existing Medicaid requirements around cost-sharing or the scope of covered services that states must provide to eligible beneficiaries.
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