What does Preamble of Primary and Behavioral Health Care Access Act of 2026 do?

This bill proposes amendments to the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986. The proposed legislation would require group health plans and health insurance issuers to provide coverage for three primary care visits and three behavioral health care visits. These visits would be provided without the application of any cost-sharing requirements.

What does SHORT TITLE. of Primary and Behavioral Health Care Access Act of 2026 do?

This bill is formally titled the Primary and Behavioral Health Care Access Act of 2026.

What does PROHIBITION ON APPLICATION OF COST SHARING FOR CERTAIN PRIMARY of Primary and Behavioral Health Care Access Act of 2026 do?

This section amends ERISA to require group health plans and health insurance issuers offering group health insurance coverage to provide coverage for a minimum of three primary care visits and three behavioral health care visits annually. Cost-sharing requirements are prohibited for these specified primary and behavioral health care visits. Treatment limitations for these visits cannot be more restrictive than those applied to other primary or behavioral health care visits covered by the plan. Reimbursement rates for these visits must be the same as those for other covered visits. The definition of 'behavioral health care visit' includes services related to the diagnosis, treatment, screening, or prevention of a behavioral health condition provided by a qualified provider. ‘Primary care service’ is defined by HCPCS codes 99201 through 99215 (and subsequent modifications by the Secretary of Health and Human Services). A 'qualified provider' for primary care visits includes general practitioners, family physicians, and other specified medical professionals, while a qualified provider for behavioral health care visits includes individuals whose primary function is the direct treatment or recovery support of individuals with behavioral health disorders.

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Primary and Behavioral Health Care Access Act of 2026

Last updated: 6/11/2026 · Introduced: 6/11/2026

Author: Angus King (I-ME)

TL;DR (AI)

The bill mandates that group health plans and health insurance issuers cover at least three primary care visits and three behavioral health care visits annually.
It prohibits cost-sharing requirements and restrictive treatment limitations for these covered primary and behavioral health care visits.
The legislation defines 'behavioral health care visit' and 'primary care service' to clarify the scope of covered services and qualified providers.

119th Congressin committeeOfficial page

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Other Sections

Includes provisions on preamble, short title., and 1 more.

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