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IRS Issues Guidance Relating to High Deductible Health Plans and Coronavirus Testing

Client Alert

In response to the Coronavirus/COVID-19 pandemic, the IRS has released guidance in Notice 2020-15 relating to the testing and treatment for individuals covered by a High Deductible Health Plan (HDHP).

Under normal circumstances, an HDHP will fail to satisfy the requirements of an HDHP if it provides coverage for testing or treatment before the annual minimum deductible has been met (subject to certain enumerated well-known exceptions for wellness and preventative care). A plan disqualification would prohibit participants in the HDHP from making contributions to their Health Savings Account as HSAs require coverage by an HDHP.

The Notice provides that an HDHP will not fail to qualify as an HDHP “merely because the health plan provides medical care services and items purchased related to testing for and treatment of COVID-19 prior to the satisfaction of the applicable minimum deductible.” As a result, the fact that an individual is covered by an HDHP will not be impacted by free or reduced charges for testing and treatment of Coronavirus/COVID-19, regardless of whether or not they have met the deductible requirements under the HDHP.

While the IRS has chosen to provide this relief for both HDHPs and those individuals who receive their coverage through such a plan, this announcement has no impact on whether or not an insurance carrier will take any action regarding coverage for these items. Please contact your insurance carrier to determine what, if any, accommodation or arrangement they are making in light of the pandemic.

For questions on this topic or any other tax-related questions for your business, please contact Priscilla Grant at (330) 253-5934 or pagrant@bmdllc.com.


Advanced Practice Providers and Telemedicine Start-Up Surge

Throughout the COVID-19 pandemic, we heard a lot about “surges” that happened all over the country regarding the virus. One of the other interesting “surges” we have followed is the “surge” in new healthcare business start-ups, particularly businesses owned by advanced practice providers, such as nurse practitioners, physician assistants, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists (“Advanced Practice Providers” or “APPs”). One of the hottest areas in the healthcare start-up surge has been the creation of practices that are telemedicine focused.

Ohio Department of Health Releases Updated Charge Limits for Medical Records

Under Ohio law, a healthcare provider or medical records company that receives a request for a copy of a patient's medical record may charge an amount in accordance with the limits set forth in Ohio Revised Code Section 3701.741. The allowable amounts are increased or decreased annually by the average percentage of increase or decrease in the consumer price index for all urban consumers, prepared by the United States Department of Labor, Bureau of Labor Statistics, for the immediately preceding calendar year over the calendar year immediately preceding that year, as reported by the Bureau. The Director of the Ohio Department of Health makes this determination and adjusts the amounts accordingly. The list is then published, here.

No Surprises Act Compliance (Published by NAMAS, 2/25/22)

The Department of Health and Human Services published three parts to the No Surprises Act towards the end of 2021, which took effect January 1, 2022. The Act is intended to protect consumers from “balance billing,” which occurs when a patient receives a bill with a higher price than they may have anticipated because they did not have knowledge that the provider or facility was out-of-network. The purpose of this article is to note certain requirements that compliance employees will need to be aware of at their facilities, including notice and consent, good faith estimates, and public disclosures.

No Surprises Act and You (Published in the SCMS Winter 2022 Newsletter)

Legislation has been adopted by the United States Congress and the Ohio Legislature known as the “No Surprises Act” which attempts to regulate billing by professionals and facilities to patients who are not in networks with those facilities or providers at those facilities. The federal bill was triggered by some sensational news stories of patients being billed for tens of thousands of dollars for emergency care when the hospital was out of the network under the patient’s insurance plans.

Are You Impacted by the Project Labor Agreement Executive Order?

Project Labor Agreements (PLAs) are a quasi-collective bargaining agreement between employers and unions. They establish the terms and conditions of employment, including dispute resolution. They are put into place on specific projects and apply to the contractor, whether it is union or non-union. Employees hired on the project will be treated as union.