Proposal Introduced to Expand Primary & Behavioral Health Care Access
Senator Angus King (I-ME) has introduced the Primary and Behavioral Health Care Access Act of 2022 (the Act). The Act would amend the Employee Retirement Income Security Act, the Internal Revenue Code, and the Public Health Service Act to require group health plans or health insurance issuers to provide three primary care visits and three behavioral health care visits without cost-sharing. If enacted, the Act would be effective two years following its enactment.
Under the Affordable Care Act, group health plans are currently required to cover preventive visits without any cost sharing from a participant. Preventive services generally include evidence-based items or services with an “A” or “B” rating, immunizations for routine use, evidence-informed preventive care and screenings provided for in government guidelines for women and children. The Act would expand the cost-sharing prohibition to any three primary care visits with medical codes 99201 through 99215 (i.e., office or other outpatient visits) and any three behavioral health care visits. Under current law, the primary care visits and the behavioral health care visits may already prohibit cost-sharing if the visit is preventive. But to the extent the visit is to diagnose or treat an illness, the Act would ensure that the medical visit would not impose any cost sharing on participants.
Finally, the Act would amend the Internal Revenue Code to ensure that any primary care visit or behavioral health care visit would not prevent an individual from contributing to a health savings account.