“There is currently a lack of clarity in the tax code about how Direct Primary Care (DPC) agreements should be treated vis-à-vis Health Savings Accounts (HSAs). The Internal Revenue Code (IRC) clearly states that HSAs must be paired with a high deductible health plan (HDHP). Section 223(c) of the IRC also prohibits individuals with HSAs from having a second health plan to cover services not covered by the HDHP. Current Treasury Department interpretation of the IRC treats DPC monthly fee arrangements like a second health plan, rather than a payment for a medical service. As such, under current policy, individuals with HSAs are effectively barred from having a relationship with a DPC provider, because the DPC agreement makes the individual ineligible to fund the HSA. However, 23 states have passed laws defining DPC as a medical service outside of health plan or insurance regulation.” ~DPC Coalition; http://www.dpcare.org
By Michael Tetreault, Editor-in-Chief | The DPC Journal
November 15, 2017 | Run Time: 31:35
Listen in as Jay Keese, Executive Director of The Direct Primary Care Coalition (DPCare.org) and Michael Tetreault, Editor of The DPC Journal … Discuss a Variety of the The Federal and Statewide Efforts Happening Across The U.S. To Clarify Private, Direct Pay Healthcare Language.
We talk about the following issues:
- Who should pay for the private, direct pay subscription fees;
- Defining DPC in Pennsylvania, Arizona, Oregon, Florida, South Carolina, Georgia, West Virginia and Virginia Updates;
- Missouri Medicaid Pilot;
- 2017 action items accomplished;
- DPC, HSAs and 2016 Year-End Devenir HSA Research Report
- Key Findings
- HSA accounts now exceed 20 million. The number of HSA accounts rose to 20 million, holding almost $37 billion in assets, a year over year increase of 22% for HSA assets and 20% for accounts for the period of December 31st, 2015 to December 31st, 2016. HSA investments see continued growth. HSA investment assets reached an estimated $5.5 billion in December, up 29% year over year. The average investment account holder has a $14,971 average total balance (deposit and investment account). Health plans remain the largest driver of account growth. Health plan partnerships continued as the leading driver of new account growth, accounting for 37% of new accounts opened in 2016.
- Key Findings
- Michigan Medicaid Pilot;
- Employers and Tax Treatment of Direct Primary Care & Concierge Medicine with Health Savings Accounts (HSAs) ;
- Lack of Definitions in Some States;
- The Primary Care Enhancement Act (H.R. 365 and S. 1358)
- 2017 & 2018 challenges;
- 2018 solutions proposed in 2017;
- 2018 policy questions still need to be answered and addressed in the space;
- The ACA;
- initiatives that may help moonlighting and financially challenged DPC Physicians across the U.S. to add more revenue to their practice;
- what still needs to be done legislatively in certain states;
- how flexible should the DPC model be to match existing state or federal laws;
- who should and should not consider DPC;
- What will practicing as a DPC Physician Look Like in the next 2-3 years?
- and more.
The Direct Primary Care Coalition’s mission is to support DPC, an innovative, non-partisan approach to better primary care. The central tenets of this movement are based on a culture of service, patient empowerment, trusting relationships supported by unrushed care, rejection of FFS insurance incentives, excellence of medical care and promotion of health. To learn more, participate or become part of the the DPC Coalition policy activities, visit https://www.dpcare.org/join
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