SAN RAMON, Calif. The Special Interest Group for IIAS Standards announced Wednesday that the group is making significant changes to its Eligible Products List — a list of over-the-counter products eligible for reimbursement under flexible spending accounts — in response to IRS guidance issued earlier this month.
That guidance, issued by the IRS in Notice 2010-59 in response to changes made by the Affordable Care Act, requires a doctor’s prescription for the reimbursement of over-the-counter drug and medicines from health plans and tax-advantaged healthcare accounts.
Based on this IRS guidance, the SIGIS Eligible Products List committee completed a thorough review of the list and determined that just more than 15,000 items are impacted and will need to be removed. Even after this significant reduction, more than 27,000 OTC items remain on the list for purchase without a prescription and through a Health Care Debit Card at SIGIS-certified merchants without the need for further substantiation. Items that continue to be eligible without a prescription include such items as insulin, medical devices (crutches, blood sugar monitors, etc.), bandages, contact lens solution and denture bond.
Though the IRS rule goes into effect on Jan. 1, 2011, SIGIS is releasing a summary of the edits to help SIGIS members begin to prepare for this significant change, the group noted. The detailed SIGIS Eligible Products List will be published on Dec. 15. In the guidance, the IRS granted transitional relief for IIAS merchants, so that IIAS merchants will actually have until Jan. 15, 2011, to update their systems to be compliant with the new guidance.
The following categories have been removed from the Eligible Products List to prevent them from being purchased at an IIAS merchant without a prescription. Categories no longer eligible without a prescription include:
SIGIS was formed to create a standard industry solution that could be both scaleable and broadly adoptable, while being consistent with IRS requirements. The group includes all stakeholders involved with the process, from pharmacy merchants through plan administrators.