the Public Health Service Act ( 42 U.S.C. 300gg ), subtitle B of title I of the Employee Retirement and Income Security Act of 1974 ( 29 U.S.C. 1021 et seq.), PPACA, and this Act, the offering of concierge medicine shall not be treated as the offering of health insurance coverage and shall not be subject to regulations as such coverage under such Acts. (2) Concierge medicine defined In this subsection, the term concierge medicine means the furnishing (or access to the furnishing) by a physician or group of physicians of physician professional services (and ancillary services) in return for payment of a monthly or other prepaid amount. III State flexibility in regulation of health insurance coverage 301. State flexibility in regulation of health insurance coverage (a) In general States are given the flexibility under section 122(b) to revise their regulations of the health insurance marketplace, without regard to many of the requirements imposed under PPACA, in order to promote freedom of choice of affordable health insurance coverage options offered outside of an Exchange. (b) Construction Nothing in the Employee Retirement and Income Security Act of 1974 ( 29 U.S.C. 1001 et seq.) or of any amendments made by the Health Insurance Portability and Accountability Act of 1996 ( Public Law 104–191 ) shall be interpreted as preventing an employer from offering, or making an employer contribution towards, individual health insurance coverage for employees and dependent family members. (c) Association health plans Nothing in this Act shall be construed as prohibiting the formation of association health plans (as defined under State law). (d) High-Risk pools Nothing in this Act shall be construed as prohibiting States from establishing pooling arrangements for high-risk individuals. IV Medicaid Payment Reform 401. Medicaid payment reform (a) In general Title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) is amended by inserting after section 1903 the following section: 1903A. Reformed payment to States (a)