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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.


What Inpatient Behavioral Health Providers Need to Know About ODM's New Draft Rule for Reimbursements

Ohio Department of Medicaid (ODM) recently released a draft rule that will transform how inpatient behavioral health services are reimbursed for some hospitals. ODM will migrate inpatient payments for behavioral health and substance use disorder services (BH/SUD) provided by freestanding psychiatric hospitals (FSPs) from the APR-DRG payment methodology to a per diem payment methodology derived from the APR-DRG system.

BMD Named to the 2024 U.S. News – Best Lawyers® “Best Law Firms”

Brennan Manna & Diamond (BMD) is recognized among the leading law firms in the nation according to the 2024 Edition of U.S. News – Best Lawyers®  "Best Law Firms." The firm has ranked in in 13 practice areas and has earned “National Tier 1” rankings in Health Care Law and Litigation-Trusts & Estates.

Friendly Physician Models: The Basics Through 5 Frequently Asked Questions

During the past several years, many health law practices have noticed a dramatic increase in the number of telehealth businesses and private equity backed health care providers. Both of these trends often rely heavily on corporate structures commonly referred to as “friendly physician,” “captive PC” or “MSO” models. Although friendly physician models are used by non-physician health care providers (e.g., physical therapists, psychologists, and dentists), this article focuses on physicians and how the model is used in connection with the provision of professional medical services.

The DOL and EEOC Enter a Partnership to Strengthen Federal Employment Law Enforcement

On September 13, the U.S. Department of Labor’s (DOL) Wage and Hour Division and the Equal Employment Opportunity Commission (EEOC) entered into a Memorandum of Understanding (MOU) agreeing to work together in enforcing federal employment laws. The MOU forms a partnership between the two agencies to encourage coordination through information sharing, joint investigations, training, and outreach.

Proposed Laboratory Arrangement Draws Heightened Scrutiny from the OIG

On September 25, 2023, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) issued Advisory Opinion 23-06 (AO). The Opinion involved a proposed arrangement between an independent laboratory and other physician laboratories for the purchase of the technical component of anatomic pathology services. The OIG ultimately concluded that the arrangement at issue, if it was entered into with the requisite intent, would implicate the Federal Anti-Kickback Statute (AKS) and constitute grounds for sanctions.