Chronic Disease Management Act of 2019

II 116TH CONGRESS 1ST SESSION S. 1948 To amend the Internal Revenue Code of 1986 to permit high-deductible health plans to provide chronic disease prevention services to plan enroll- ees prior to satisfying their plan deductible. IN THE SENATE OF THE UNITED STATES JUNE 24, 2019 Mr. THUNE (for himself and Mr. CARPER) introduced the following bill; which was read twice and referred to the Committee on Finance 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 Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE; FINDINGS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Chronic Disease Management Act of 2019’’. 5 (b) FINDINGS.—Congress finds the following: 6 VerDate Sep 11 2014 20:54 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1948.IS S1948 jspears on DSK30JT082PROD with BILLS 2 •S 1948 IS (1) A small number of chronic diseases account 1 for the majority of health care spending in the 2 United States. 3 (2) The Office of the Assistant Secretary for 4 Health of the Department of Health and Human 5 Services used a deliberative process involving the 6 Multiple Chronic Conditions working group subject 7 matter experts in clinical medicine, epidemiology, 8 and public health to develop a list of 20 chronic con- 9 ditions that are prevalent and potentially amenable 10 to public health or clinical interventions, or a com- 11 bination of both. 12 (3) Limited and targeted interventions for 13 many chronic diseases prevent the need for addi- 14 tional, more costly therapies associated with un- 15 treated or unmanaged chronic diseases that lead to 16 adverse effects on quality of life for patients. 17 (4) These types of chronic care preventive serv- 18 ices should be encouraged to maximize the effective- 19 ness and positive outcomes of the care provided 20 under high-deductible health plans. 21 (5) Section 223(c)(2)(C) of the Internal Rev- 22 enue Code of 1986 explicitly grants the Secretary of 23 the Treasury flexibility in defining the scope of pre- 24 ventive care for purposes of the preventive care safe 25 VerDate Sep 11 2014 04:00 Jun 27, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1948.IS S1948 jspears on DSK30JT082PROD with BILLS 3 •S 1948 IS harbor. As of the date of introduction of this Act, 1 the Secretary of the Treasury has refrained from ex- 2 ercising existing authority under such section to ex- 3 pand the preventive care safe harbor to include 4 chronic disease prevention. 5 (6) In the absence of an expansion of the pre- 6 ventive care safe harbor by the Secretary of the 7 Treasury, the Chronic Disease Management Act of 8 2019 would expressly permit high-deductible health 9 plans to provide chronic disease prevention and 10 treatment, subject to certain limitations, prior to a 11 plan enrollee having met their plan deductible. 12 (7) Allowing health savings account-eligible 13 high-deductible health plans to cover chronic disease 14 prevention and treatment on a pre-deductible basis 15 promotes the concept of Value-Based Insurance De- 16 sign, which is an effective tool to improve the quality 17 and reduce the cost of care for Americans with 18 chronic diseases, with improved outcomes via in- 19 creased medication adherence, reduced complica- 20 tions, and decreased emergency department visits. 21 SEC. 2. CHRONIC DISEASE PREVENTION. 22 (a) IN GENERAL.—Section 223(c)(2) of the Internal 23 Revenue Code of 1986 is amended by redesignating sub- 24 VerDate Sep 11 2014 04:00 Jun 27, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1948.IS S1948 jspears on DSK30JT082PROD with BILLS 4 •S 1948 IS paragraph (D) as subparagraph (E) and by inserting after 1 subparagraph (C) the following new subparagraph: 2 ‘‘(D) SAFE HARBOR FOR ABSENCE OF DE- 3 DUCTIBLE FOR CARE RELATED TO CHRONIC 4 CONDITIONS.—A plan shall not fail to be treat- 5 ed as a high-deductible health plan by reason of 6 failing to have a deductible for care related to 7 the treatment of any chronic condition, as de- 8 termined by the Assistant Secretary for Health 9 of the Department of Health and Human Serv- 10 ices.’’. 11 (b) EFFECTIVE DATE.—The amendments made by 12 this section shall apply to coverage for months beginning 13 after the date of the enactment of this Act. 14 Æ VerDate Sep 11 2014 04:00 Jun 27, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\S1948.IS S1948 jspears on DSK30JT082PROD with BILLS