On Thursday, February 8th, 2018, Senators John Thune (R-SD) and Tom Carper (D-DE), and Representatives Diane Black (R-TN) and Earl Blumenauer (D-OR), introduced the Chronic Disease Management Act of 2018 (S.2410 and H.R. 4978) in the House of Representatives and the Senate. The bipartisan bill states, “Allowing health savings account-eligible high-deductible health plans to cover chronic disease prevention and treatment on a pre-deductible basis promotes the concept of Value-Based Insurance Design, which is an effective tool to improve the quality and reduce the cost of care for Americans with chronic diseases, with improved outcomes via increased medication adherence, reduced complications, and decreased emergency department visits.”
The bill amends IRS Section 223 (c)(2)(C):
(a) IN GENERAL—Section 223(c)(2) of the Internal Revenue Code of 1986 is amended
by redesignating subparagraph (D) as subparagraph (E) and by inserting after
subparagraph (C) the following new subparagraph:
‘‘(D) SAFE HARBOR FOR ABSENCE OF DEDUCTIBLE FOR CARE RELATED TO
CHRONIC CONDITIONS—A plan shall not fail to be treated as a high deductible health
plan by reason of failing to have a deductible for care related to the treatment of any
medically complex chronic condition which—
(i) is substantially disabling or life threatening,
(ii) has a high risk of hospitalization or other significant adverse health outcomes, and
(iii) requires specialized delivery systems across domains of care.”
This amendment to the IRS code would provide health savings account eligible high-deductible health plans (HSA-HDHPs) the flexibility to cover services and drugs used to treat chronic diseases before meeting the plan deductible.
What does this mean, and why is it important?
This bill allows for the development and implementation of High-Value Health Plans. Adoption of this voluntary, clinically nuanced HVHP has the potential to mitigate cost-related non-adherence, enhance patient-centered outcomes, allow for premiums lower than most PPOs and HMOs, and substantially reduce aggregate health care expenditures. The HVHP would provide millions of Americans a plan option that better meets their clinical and financial needs.
View the resources below for more information on HVHPs.