IRS Releases Guidance for HDHPs on Preventive Care Before Reaching Deductible

Published June 23, 2023

The Internal Revenue Service (IRS) has released Notice 2023-37 on the high deductible health plan (HDHP) preventive care safe harbor specific to 1) COVID-19 testing and 2) recommendations with an “A” or “B” rating by the United States Preventive Services Task Force (USPSTF).

COVID-19 testing and screening
IRS has determined that, with the end of the COVID-19 National Emergency and the Public Health Emergency, the relief described in Notice 2020-15 is no longer needed. Accordingly, Notice 2020-15 applies only with respect to plan years ending on or before December 31, 2024. For subsequent plan years, an HDHP is not permitted to provide health benefits associated with testing for and treatment of COVID-19 without a deductible, or with a deductible below the minimum deductible (for self-only or family coverage) for an HDHP, except as otherwise provided in this notice.

IRS Notice 2023-37 states that the preventive care safe harbor, as described in Notice 2004-23, does not include COVID-19 testing effective June 23, 2023, although HDHPs may continue to provide benefits related to testing for COVID-19 before satisfaction of the applicable minimum deductible for plan years ending on or before December 31, 2024.

Recommendations with an “A” or “B” rating by the USPSTF

Consistent with the position taken in Question and Answer 7 of DOL FAQs Part 59, IRS Notice 2023-37 provides that items and services recommended with an “A” or “B” rating by the USPSTF on or after March 23, 2010, are treated as preventive care for purposes of the HDHP safe harbor, regardless of whether these items and services must be covered, without cost sharing, referencing pending litigation (Braidwood v. Becerra).