The Internal Revenue
Service (IRS) has issued a notice that expands preventative care benefits for
high deductible health plans. Prior to this notice,
care and services for an existing or chronic condition were not included as
preventative. The IRS and the Department of Health and Human Services (HHS)
determined that certain medical care services received and items purchased,
including prescription drugs for certain chronic conditions, should be
classified as preventative care.
These medical services and items are limited to
the specific medical care services or items listed for the associated chronic
conditions specified in Notice 2019-45. The treasury has noted that each medical
service, when prescribed for an individual with the related chronic condition,
should be characterized by the following:
- The service or item is
low-cost.
- There is medical evidence
supporting high-cost efficiency (a large expected impact) of preventing
exacerbation of the chronic condition or the development of a secondary
condition.
- There is a strong likelihood,
documented by clinical evidence, that with respect to the class of
individuals prescribed the item or service, the specific service or use of
the item will prevent the exacerbation of the chronic condition or the
development of a secondary condition that requires significantly
higher-cost treatments.
Any medical care
previously recognized as preventive care for these rules is still treated as
preventive care.
From BenefitMall August 7, 2019
