President Biden recently signed The Consolidated Appropriations Act, 2022 (CAA) into law. As part of the 2022 CAA, COVID-related telehealth coverage can be covered at no cost-share for High Deductible Health Plans (HDHPs) in a similar fashion to what was allowed under the CARES Act starting April 1, 2022 through December 31, 2022. The Coronavirus Aid, Relief and Economic Security Act (CARES Act) allowed first-dollar telehealth coverage under HDHPs. This relief allowed participants to utilize telehealth services prior to satisfying the plan’s deductible without risk of disqualification, which would prevent continuing contributions to a health savings account (HSA). The relief afforded under the CARES Act ended December 31, 2021, thus highlighting a need for additional relief, either temporary or permanent. While it is unclear whether permanent legislation expanding telehealth coverage in this manner will be enacted, the new relief, although temporary, comes as welcome news to participants and plan sponsors.
This provision under the CAA is optional for plan sponsors and cannot be applied retroactively, therefore any non-preventive telehealth services administered between January 1, 2022 and March 31, 2022 would remain subject to the HDHP’s deductible. Additionally, non-calendar year plans that choose to adopt the change should be conscientious of the fact that it will not be applicable for the entire plan year. Mid-year changes would need to be made and non-preventive telehealth services would again be subject to the HDHP deductible as of January 1, 2023.
Employer Next Steps:
There are a few next steps employers can take if they are considering adopting this flexibility:
- Confirm with vendors and third-party administrators if the relief will be permitted (if fully-insured) or that their system can accommodate the relief (if self-insured)
- Communicate to employees whether or not the relief will be adopted and highlight what the relief means for their HDHPs and HSAs, specifically consider highlighting that the relief is temporary starting April 1, 2022 through December 31, 2022 and will not be retroactive to the beginning of the 2022 plan year
- Update SPDs to explain adopted changes and/or send SMMs to plan participants
Additional Telehealth Flexibilities Extended Under the CAA
In addition to providing relief for HDHPs, the CAA also extended certain telehealth flexibilities for Medicare patients for 151 days after the official end of the federal public health emergency, which currently is set to end in mid-April, unless further extended. The flexibilities include:
- Waiving the originating site requirement for telehealth services, therefore allowing providers to receive Medicare payment for delivering telehealth services to patients at home
- Expanding the list of telehealth practitioners able to deliver Medicare covered telehealth services to include qualified occupational therapists, speech language pathologists, physical therapists and audiologists
- Covering audio-only telehealth services under temporary waivers
- Delaying the in-person requirement for Medicare covered mental health services
- Allowing federally qualified health centers and rural health centers to serve as distant sites for telehealth services
The full text of the Consolidated Appropriations Act, 2022 can be found here. We will continue to monitor any further developments including any additional guidance related to retroactive application of the telehealth flexibilities related to HDHP and provide updates as they become available.
2022 Employer Compliance Calendar
Are you finding it difficult to keep up with the constant changes in the compliance landscape? We understand that HR professionals have other important items on their plate so we have put together a 17 page calendar that will insure employers are meeting deadlines to remain compliant in the workplace. Click below to download our calendar!
