Health Care Spending Accounts Require Prescriptions for OTC Medications under Patient Protection and Affordable Care Act – November 2010
Health Care Spending Accounts Require Prescriptions for OTC Medications Under PPACA
Beginning January 1, 2011, the new health care reform law will change existing rules associated with spending accounts for HRAs, HSAs, FSAs and MSAs. Members with these spending accounts will be able to use their account funds for OTC medications or prescription drugs only if the medication or drug is prescribed by a doctor (or another health care professional who is legally authorized to issue a prescription) in the state in which the drug is purchased. Insulin is the only exception to this requirement.
This new requirement will apply to OTC medications and prescription drugs that are purchased on or after January 1, 2011. This effective date applies to all plans, regardless of grandfathered status or renewal dates for policies. These rules do not apply to OTC items that are not medications or drugs, including equipment (such as crutches), supplies (such as bandages) and diagnostic services (such as glucometers). If patients purchase OTC medications in 2010, but submit for reimbursement in 2011, a prescription is not required.