Title: Chronic Disease Management Act of 2018
Policy area: Taxation

Summary:
Chronic Disease Management Act of 2018
This bill amends the Internal Revenue Code, with respect to health savings accounts (HSAs), to allow the high deductible health plans required for an HSA to provide care for chronic conditions with no deductible. The bill covers care and prescription medicines related to the treatment of medically complex chronic conditions which: (1) are substantially disabling or life threatening, (2) have a high risk of hospitalization or other significant adverse health outcomes, and (3) require specialized delivery systems across domains of care.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4978 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 4978

 To amend the Internal Revenue Code of 1986 to permit high-deductible 
  health plans to provide chronic disease prevention services to plan 
          enrollees prior to satisfying their plan deductible.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 8, 2018

 Mrs. Black (for herself and Mr. Blumenauer) introduced the following 
      bill; which was referred to the Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
 To amend the Internal Revenue Code of 1986 to permit high-deductible 
  health plans to provide chronic disease prevention services to plan 
          enrollees prior to satisfying their plan deductible.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Chronic Disease 
Management Act of 2018''.
    (b) Findings.--Congress finds the following:
            (1) A small number of chronic diseases account for the 
        majority of health care spending in the United States.
            (2) Limited and targeted interventions for many chronic 
        diseases prevent the need for additional, more costly therapies 
        associated with untreated or unmanaged chronic diseases that 
        lead to adverse effects on quality of life for patients.
            (3) These types of chronic care preventive services should 
        be encouraged to maximize the effectiveness and positive 
        outcomes of the care provided under high-deductible health 
        plans.
            (4) Section 223(c)(2)(C) of the Internal Revenue Code of 
        1986 explicitly grants the Secretary of the Treasury 
        flexibility in defining the scope of preventive care for 
        purposes of the preventive care safe harbor. As of the date of 
        introduction of this Act, the Secretary of the Treasury has 
        refrained from exercising existing authority under such section 
        to expand the preventive care safe harbor to include chronic 
        disease prevention.
            (5) In the absence of an expansion of the preventive care 
        safe harbor by the Secretary of the Treasury, the Chronic 
        Disease Management Act of 2018 would expressly permit high-
        deductible health plans to provide chronic disease prevention 
        and treatment, subject to certain limitations, prior to a plan 
        enrollee having met their plan deductible.
            (6) Allowing HSA-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.

SEC. 2. CHRONIC DISEASE PREVENTION.

    (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 and 
                prescription medicines related to the treatment of 
                medically complex chronic conditions which--
                            ``(i) are substantially disabling or life 
                        threatening,
                            ``(ii) have a high risk of hospitalization 
                        or other significant adverse health outcomes, 
                        and
                            ``(iii) require specialized delivery 
                        systems across domains of care.''.
    (b) Effective Date.--The amendments made by this section shall 
apply to coverage for months beginning after the date of the enactment 
of this Act.
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