Due to the end of the COVID-19 public health and national emergencies, the Internal Revenue Service (IRS) has issued guidance to high-deductible health plans (HDHPs) in the form of Notice 2023-37. This notice provides guidance on COVID-19 expenses for and clarifies items and services related to preventive care under health savings account (HSA) eligibility rules.
Under its 2020 guidance, the IRS allowed HDHPs to provide COVID-19 testing and treatment benefits with no or low deductibles (below the applicable HDHP minimum deductible). This guidance allowed individuals to receive benefits for these services without adversely affecting their HSA eligibility.
However, since the public health and national emergencies have ended, the 2020 guidance is no longer necessary. As a result, the 2020 guidance will apply only to plan years ending on or before December 31, 2024.
Furthermore, the IRS previously issued guidance concerning the preventive care safe harbor. Under the safe harbor, HDHPs can offer certain preventive care items and services on a no or low-deductible basis. This guidance clarifies that the preventive care safe harbor does not include screening for COVID-19, effective as of the date of the guidance, nor does it include screening for common and episodic illnesses, such as the flu. However, it may include screening for other infectious diseases.
Likewise, consistent with the IRS FAQs issued in response to the Braidwood decision, items and services recommended by the United States Preventive Task Force (USPTF) with an “A” or “B” rating after March 23, 2010, fall within the preventive care safe harbor. These items and services are within the safe harbor regardless of whether the preventive services mandate of the Affordable Care Act (ACA) requires coverage without cost-sharing.
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