[Congressional Record Volume 165, Number 106 (Monday, June 24, 2019)]
[Senate]
[Pages S4458-S4459]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. THUNE (for himself and Mr. Carper):
  S. 1948. 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; 
to the Committee on Finance.
  Mr. THUNE. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1948

       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 2019''.
       (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) The Office of the Assistant Secretary for Health of the 
     Department of Health and Human Services used a deliberative 
     process involving the Multiple Chronic Conditions working 
     group subject matter experts in clinical medicine, 
     epidemiology, and public

[[Page S4459]]

     health to develop a list of 20 chronic conditions that are 
     prevalent and potentially amenable to public health or 
     clinical interventions, or a combination of both.
       (3) 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.
       (4) 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.
       (5) 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.
       (6) In the absence of an expansion of the preventive care 
     safe harbor by the Secretary of the Treasury, the Chronic 
     Disease Management Act of 2019 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.
       (7) Allowing health savings account-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 related to the treatment of any 
     chronic condition, as determined by the Assistant Secretary 
     for Health of the Department of Health and Human Services.''.
       (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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