Requirement to substantiate distributions from health savings accounts that are for qualified medical expenses

(a) In general Section 223(d)(2), as amended by the preceding provisions of this Act, is amended by adding at the end the following new subparagraph: (F) Substantiation requirement (i) In general An amount paid or distributed from a health savings account shall not be treated as used to pay a qualified medical expense unless such amount is substantiated as a qualified medical expense. (ii) Assessment required In the case of any expense with respect to which a provider’s opinion is required to substantiate such expense as a qualified medical expense under clause (i), such opinion shall not constitute substantiation unless— (I) such opinion is based on an assessment conducted pursuant to a bona fide provider-patient relationship, (II) such assessment is conducted in-person or is an assessment of a type that generally accepted standards of medical practice do not require to be in-person, and (III) the expense is incurred for an item or service of a type that would be typically recommended under generally accepted standards of medical practice. (G) Regulations The Secretary shall issue such regulations or other guidance as may be necessary or appropriate to carry out the purposes of this subparagraph.. (b) Determination by trustee Section 223(d)(1) is amended by adding at the end the following new subparagraph: (F) In the case of any amount paid or distributed from the trust, the trustee shall determine, consistent with the requirements of paragraph (2)(F), whether such amount has been substantiated as a qualified medical expense.. (c) Effective date The amendments made by this section shall apply to amounts paid or distributed from a health savings account after December 31, 2025.