,,ii  #aafth ,,congress  #ast ,session  
,s4 #aidh  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #bd1     
#bjai,mr4 ,thune 7for himself and ,mr4  
,carper7 introduced the following bill2 
which was read twice and referred to the
 ,committee on ,finance  ,a ,,bill  ,to 
amend the ,internal ,revenue ,code of   
#aihf to permit high-deductible health  
plans to provide chronic disease        
prevention services to plan enrollees   
prior to satisfying their plan          
deductible4  #a4 ,short title2 findings 
7a7 ,short title ,this ,act may be cited
 as the ,chronic ,disease ,management   
,act of #bjai4  7b7 ,findings ,congress 
finds the following3 7#a7 ,a small      
number of chronic diseases account for  
the majority of health care spending in 
the ,united ,states4  7#b7 ,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 medicine1    
epidemiology1 and public health to      
develop a list of #bj chronic conditions
 that are prevalent and potentially     
amenable to public health or clinical   
interventions1 or a combination of both4
  7#c7 ,limited and targeted            
interventions for many chronic diseases 
prevent the need for additional1 more   
costly therapies associated with        
untreated or unmanaged chronic diseases 
that lead to adverse effects on quality 
of life for patients4  7#d7 ,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 plans4  7#e7 ,section            
#bbc7;c77#b77;,c7 of the ,internal      
,revenue ,code of #aihf explicitly      
grants the ,secretary of the ,treasury  
flexibility in defining the scope of    
preventive care for purposes of the     
preventive care safe harbor4 ,as of the 
date of introduction of this ,act1 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 prevention4     
7#f7 ,in the absence of an expansion of 
the preventive care safe harbor by the  
,secretary of the ,treasury1 the        
,chronic ,disease ,management ,act of   
#bjai would expressly permit            
high-deductible health plans to provide 
chronic disease prevention and          
treatment1 subject to certain           
limitations1 prior to a plan enrollee   
having met their plan deductible4  7#g7 
,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     
,design1 which is an effective tool to  
improve the quality and reduce the cost 
of care for ,americans with chronic     
diseases1 with improved outcomes via    

increased medication adherence1 reduced 
complications1 and decreased emergency  
department visits4  #b4 ,chronic disease
 prevention  7a7 ,in general ,section   
#bbc7;c77#b7 of the ,internal ,revenue  
,code of #aihf is amended by            
redesignating subparagraph 7,d7 as      
subparagraph 7,e7 and by inserting after
 subparagraph 7,c7 the following new    
subparagraph3  7,d7 ,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 condition1 as  
determined by the ,assistant ,secretary 
for ,health of the ,department of       
,health and ,human ,services4  4  7b7   
,effective date ,the amendments made by 
this section shall apply to coverage for
 months beginning after the date of the 
enactment of this ,act4