with independent physicians, independent physician practices, and primary care practices for purposes of furnishing medical assistance under State plans (or waivers of such plans) under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ). (c) Rule of construction Nothing in this section shall be construed to alter statutory limits on Medicaid enrollee cost-sharing or be construed to limit Medicaid services solely to those provided under a direct primary care arrangement.