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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.


CMS to Once Again Reprocess Outpatient Clinic Claims

The Hospital Outpatient Prospective Payment System (OPPS) Rule was passed in November 2018, which was intended to prevent the Centers for Medicare and Medicaid Services (CMS) from paying more for services rendered in outpatient settings than what they paid for the same services rendered in physician offices that are simply owned by hospitals or health systems.[1]

New Vaccine Requirement for Select CMS-Participating Facilities

On November 4, 2021, the Centers for Medicare and Medicaid (“CMS”) released a new rule requiring certain healthcare facilities to implement policies requiring employees to be vaccinated against COVID-19. It does not matter if a staff member does not perform patient treatment services, they must still be vaccinated if an employee of an applicable facility.

OSHA COVID-19 EMERGENCY TEMPORARY STANDARD (ETS) Vaccination, Testing, Recordkeeping, and Reporting

The Occupational Safety and Health Administration has issued its long-awaited COVID-19 Emergency Temporary Standard (ETS). Note that the ETS does not apply to employers covered under the Safer Federal Workforce Task Force COVID-19 Workplace Safety: Guidance for Federal Contractors or Subcontractors (see here), or to settings where employees provide healthcare services subject to OSHA’s ETS for the healthcare industry (see here).

Interesting Trends Revealed in 50-State Medicaid Budget Survey

Results of the KFF annual survey of state Medicaid directors reveal some fascinating trends in Medicaid service delivery and benefit coverage. Read on for a summary of the highlights we find most noteworthy. Background As a preliminary matter, many of the trends KFF identifies and that we highlight below are no doubt a result of the Covid-19 pandemic. The pandemic triggered a public health emergency and economic crisis that resulted in increased Medicaid enrollment, service offerings, and flexibility in service delivery, along with a heightened awareness of disparities in access to care and health outcomes.

Changes to Physician Assistant Statutes in Florida

In the last year, there have been many changes to the scope of practice and collaboration/supervision requirements for advanced practice providers such as APRNs and physician assistants in the state of Florida. In a previous Client Alert we discussed House Bill 607, which expanded the autonomous practice of APRNs providing primary care services in Florida.