CAA of 2022…Whhaaaattt?

Congress recently passed the Consolidated Appropriations Act of 2022.  Readers may remember the Consolidated Appropriations Act of 2021 which included the No Surprises Act and numerous transparency-related provisions that caused (and are continuing to cause) massive upheavals in how health plans and health care providers deliver their products.

The 2022 version of the CAA contains almost nothing of relevance to health plans with one exception.  The exception involves high-deductible health plans.

Individuals who are only covered under a high-deductible health plan (HDHP) (and meet certain other requirements) may contribute to a health savings account (HSA).

• A HDHP is a plan that does not pay any benefits before the individual meets the plan’s deductible subject to certain exceptions, most notably benefits for preventive, dental, and vision care.
• As a result of legislation passed in response to the COVID-19 pandemic, benefits for telehealth and other remote care were added to the list of exceptions, but only for plan years beginning on or before December 31, 2021.

The CAA of 2022 has modified this exception.

• It allows HDHPs to pay benefits prior to satisfaction of the deductible for telehealth and remote care services rendered.
• Effective dates are April 1, 2022, and ending December 31, 2022.

Note that for many plans, this will leave an awkward gap in the period during which an HDHP may pay benefits for telehealth services.  For example, many plans have a plan year corresponding to the calendar year.  Under the current structure of the law, a HDHP could pay benefits prior to exhaustion of the deductible in 2021; however, it could do so in 2022 only for telehealth services rendered after March 31.

Note too that plans may have to be formally amended in order to take advantage of the expanded access to telehealth services.