Health reform update
OTC drugs require Rx for patient reimbursement Did you know that under the new health reform law, your patients must secure a prescription for over-the-counter drugs in order to purchase them from their tax-free accounts? Effective Jan. 1, 2011, reimbursement for over-the-counter (OTC) drugs from health savings accounts (HSAs), flexible spending accounts (FSAs) and health reimbursement arrangements (HRAs) require a doctor’s prescription.
For example, a patient who suffers from allergies may ask you for a prescription for loratadine even though this drug is available without a prescription. Other medications commonly prescribed include ibuprofen and acetaminophen.
While the health care industry has been moving away from paper scripts, this change in tax law will require giving patients paper scripts for his or her tax records. We hope that working together to ensure the patient is able to use their tax-free health account will encourage medication adherence.
Preventive Health Care Guidelines We’ve updated our
Preventive Health Care Guidelines to include services now recommended as preventive by the Affordable Care Act. According to the law, preventive care includes "proven" preventive services according to the following agencies:
- U.S. Preventive Services Task Force
- Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention
- Health Resources and Services Administration
Under health reform, these services are covered at 100% for non-grandfathered health plans. Copays and deductibles may apply for members who are in grandfathered health plans or whose employer-sponsored plan has not renewed since Sept. 23, 2010, when the provision went into effect.
Questions about health reform? We recognize that many providers are also employers. Priority Health has created a website to answer employers’ questions about health reform. The site is updated as new regulations are released. Please visit
understandinghealthreform.com to learn more about this topic.
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