News & Press: Regulation

New IRS Guidance Lists Additional Low-Cost Medicines and Services That Can Be Treated as Preventive

Wednesday, July 17, 2019   (0 Comments)
Posted by: Martin Trussell
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Today, pursuant to last month’s Executive Order by President Trump on medical price transparency, the Treasury Department and the Internal Revenue Service released Notice 2019-45  which expands the types of medicines and services that can be provided under a high deductible health plan (HDHP) as preventive care for those with chronic illnesses.  Under the rules for HSAs, a high deductible plan cannot pay for medical expenses under the deductible unless the services are preventive in nature.  Under the Executive Order, Treasury and IRS were directed to consider ways to expand the use and flexibility of HSAs and HDHPs that cover low-cost preventive care. 

Under this notice, Treasury and IRS issued a list of medical services and items that would be classified as preventive care for individuals with a particular chronic condition.  The services and items have the following characteristics:
  • The service or item is low cost;
  • There is medical evidence supporting high cost efficiency of preventing exacerbation of the chronic condition or the development of a secondary condition; and
  • There is strong likelihood that this 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.
With that in mind, the Notice sets out the following services and items which will treated as preventive care for those diagnosed with the chronic illnesses listed.
Preventive Care for Specified Conditions For Individuals Diagnosed with
Angiotensin Converting Enzyme (ACE) inhibitors Congestive heart failure, diabetes, and/or coronary artery disease
Anti-resorptive therapy Osteoporosis and/or osteopenia
Beta-blockers Congestive heart failure and/or coronary artery disease
Blood pressure monitor Hypertension
Inhaled corticosteroids Asthma
Insulin and other glucose lowering agents Diabetes
Retinopathy screening Diabetes
Peak flow meter Asthma
Glucometer Diabetes
Hemoglobin A1c testing Diabetes
International Normalized Ratio (INR) testing Liver disease and/or bleeding disorders
Low-density Lipoprotein (LDL) testing Heart disease
Selective Serotonin Reuptake Inhibitors (SSRIs) Depression
Statins Heart disease and/or diabetes