【跨境合规】美国《健康保险便利和责任法案》（HIPPA）中英对照摘录（三十八）

第 322 条 符合条件的长期照护服务视作医疗费用

(a) 一般规则。对第 213 条 (d) 款（医疗费用定义）第 (1) 项作出修改：删除 (B) 项末尾的 “或者”，将原 (C) 项重新编号为 (D) 项，并在 (B) 项之后新增如下子项：

“(C) 用于符合条件的长期照护服务（定义见第 7702B 条 (c) 款），或者”。

(b) 技术性修订。

(1) 对第 213 条 (d)(1) 款 (D) 项（经本条 (a) 款重新编号后）作出修改，在句号前增加 “或者任何符合条件的长期照护保险合同（定义见第 7702B 条 (b) 款）相关支出”。

(2)(A) 对第 213 条 (d) 款第 (1) 项作出修改，在末尾新增如下独立句子：

“对于符合条件的长期照护保险合同（定义见第 7702B 条 (b) 款），仅第 (10) 项定义的合格长期照护保费，可以纳入 (D) 项的核算范围。”

(B) 对第 162 条 (l) 款第 (2) 项作出修改，在末尾新增如下子项：

“(C) 长期照护保费。对于符合条件的长期照护保险合同（定义见第 7702B 条 (b) 款），仅第 213 条 (d)(10) 款定义的合格长期照护保费，可以纳入第 (1) 项的核算范围。”

(C) 对第 213 条 (d) 款作出修改，在末尾新增如下款项：

“(10) 合格长期照护保费。

(A) 一般规定。在本条项下，‘合格长期照护保费’指纳税年度内，为覆盖个人的符合条件长期照护保险合同（定义见第 7702B 条 (b) 款）实际支付的金额，该金额不得超过下表规定限额：

纳税人在纳税年度结束前的年龄 | 限额

40 周岁及以下 | 200 美元

40 周岁以上、50 周岁及以下 | 375 美元

50 周岁以上、60 周岁及以下 | 750 美元

60 周岁以上、70 周岁及以下 | 2000 美元

70 周岁以上 | 2500 美元

(B) 指数调整机制。

(i) 一般规则。对于 1997 年之后任一公历年度起算的纳税年度，本款 (A) 项内各项金额，应按该年度医疗成本调整系数上调。依本句计算得出的上调金额若不是 10 美元的整数倍，四舍五入至最近的 10 美元整数倍。

(ii) 医疗成本调整系数。就本目而言，任一公历年度的医疗成本调整系数，指（如有）以下两者的涨幅比例：

(I) 上一公历年度 8 月消费者价格指数（定义见第 1 条 (f)(5) 款）医疗分项指数，高于

(II) 1996 年 8 月该分项指数的比例。

财政部长应当与卫生与公众服务部部长协商，确定财政部长认为比前述调整方式更适合本款项下适用的调整规则，该确定的调整规则替代前述调整规则适用。

(11) 向亲属支付的特定款项不认定为医疗费用。为个人提供符合条件长期照护服务（定义见第 7702B 条 (c) 款）而支付的款项，在满足下列情形之一时，不作为医疗费用支出：

(A) 由该个人配偶或者亲属提供该服务（直接提供，或通过合伙企业、公司、其他主体提供），除非该服务由持照专业人员提供；或者

(B) 由与该个人存在关联关系（关联关系含义参照第 267 条 (b) 款、第 707 条 (b) 款）的公司或者合伙企业提供。

本款项下，‘亲属’指与该个人存在第 152 条 (a) 款第 (1) 至 (8) 项所列亲属关系的主体。本款规定不适用于第 105 条 (b) 款项下保险报销相关情形。”

(3) 对第 213 条 (d) 款第 (6) 项作出修改：

(A) 删除 “(A) 项与 (B) 项”，替换为 “(A) 项、(B) 项与 (C) 项”；

(B) 删除 (A) 项内的 “第 (1)(C) 项”，替换为 “第 (1)(D) 项”。

(4) 对第 213 条 (d) 款第 (7) 项作出修改，删除 “(A) 项与 (B) 项”，替换为 “(A) 项、(B) 项与 (C) 项”。

(c) 生效日期。本条所作修订，适用于 1996 年 12 月 31 日之后开始的纳税年度。

第 323 条 申报义务

(a) 一般规定。对第 61 章 A 分章第 III 部分 B 子部分作出修改，在末尾新增如下条文：

“第 6050Q 条 特定长期照护保险金

(a) 申报义务。任何支付长期照护保险金的主体，应当按照财政部长规定的申报表格式与规章提交申报，申报载明：

(1) 该主体在一个公历年度内向单个个人支付的长期照护保险金总额；

(2) 该保险金是否全部或者部分按日或者其他周期定额发放，不与对应周期内实际发生费用挂钩；

(3) 该个人的姓名、地址、纳税人识别号；

(4) 被保险人（慢性病患者或者终末期病患）的姓名、地址、纳税人识别号，保险金系基于该病患的身体状况发放。

(b) 向相关主体提供书面告知书。所有负有本条 (a) 款申报义务的主体，应当向申报名单所载每名个人出具书面告知书，载明：

(1) 付款主体名称；

(2) 申报列明的、向该个人发放的长期照护保险金总额。

前述书面告知书，应当在该公历年度申报对应的次年 1 月 31 日或之前交付对应个人。

(c) 长期照护保险金定义。在本条项下，‘长期照护保险金’包括：

(1) 任何以长期照护保险名义宣传、营销、销售的产品项下支付的款项；

(2) 依据第 101 条 (g) 款可以不计入总收入的款项。”

(b) 罚则。

(1) 对第 6724 条 (d)(1) 款 (B) 项作出修改：将第 (ix) 目至第 (xiv) 目依次重新编号为第 (x) 目至第 (xv) 目，并在第 (viii) 目之后新增如下目：

“(ix) 第 6050Q 条（关于特定长期照护保险金）；”

(2) 对第 6724 条 (d) 款第 (2) 项作出修改：将 (Q) 项至 (T) 项依次重新编号为 (R) 项至 (U) 项，并在 (P) 项之后新增如下子项：

“(Q) 第 6050Q 条 (b) 款（关于特定长期照护保险金）；”

(c) 条文索引技术性修订。对第 61 章 A 分章第 III 部分 B 子部分的条文目录作出修改，在末尾新增条目：

“第 6050Q 条 特定长期照护保险金”。

(d) 生效日期。本条所作修订，适用于 1996 年 12 月 31 日之后发放的保险金。

SEC. 322. QUALIFIED LONG-TERM CARE SERVICES TREATED AS MEDICAL CARE.

(a) GENERAL RULE.—Paragraph (1) of section 213(d) (defining medical care) is amended by striking ‘‘or’’ at the end of subparagraph (B), by redesignating subparagraph (C) as subparagraph (D), and by inserting after subparagraph (B) the following new subparagraph:

‘‘(C) for qualified long-term care services (as defined in section 7702B(c)), or’’.

(b) TECHNICAL AMENDMENTS.—

(1) Subparagraph (D) of section 213(d)(1) (as redesignated by subsection (a)) is amended by inserting before the period ‘‘or for any qualified long-term care insurance contract (as defined in section 7702B(b))’’.

(2)(A) Paragraph (1) of section 213(d) is amended by adding at the end the following new flush sentence:

‘‘In the case of a qualified long-term care insurance contract (as defined in section 7702B(b)), only eligible long-term care premiums (as defined in paragraph (10)) shall be taken into account under subparagraph (D).’’

(B) Paragraph (2) of section 162(l) is amended by adding at the end the following new subparagraph:

‘‘(C) LONG-TERM CARE PREMIUMS.—In the case of a qualified long-term care insurance contract (as defined in section 7702B(b)), only eligible long-term care premiums (as defined in section 213(d)(10)) shall be taken into account under paragraph (1).’’

(C) Subsection (d) of section 213 is amended by adding at the end the following new paragraphs:

‘‘(10) ELIGIBLE LONG-TERM CARE PREMIUMS.—

‘‘(A) IN GENERAL.—For purposes of this section, the term ‘eligible long-term care premiums’ means the amount paid during a taxable year for any qualified long-term care insurance contract (as defined in section 7702B(b)) covering an individual, to the extent such amount does not exceed the limitation determined under the following table:

In the case of an individual with an attained age before the close of the taxable year of: | The limitation is:

40 or less | $ 200

More than 40 but not more than 50 | 375

More than 50 but not more than 60 | 750

More than 60 but not more than 70 | 2,000

More than 70 | 2,500

‘‘(B) INDEXING.—

‘‘(i) IN GENERAL.—In the case of any taxable year beginning in a calendar year after 1997, each dollar amount contained in subparagraph (A) shall be increased by the medical care cost adjustment of such amount for such calendar year. If any increase determined under the preceding sentence is not a multiple of $10, such increase shall be rounded to the nearest multiple of $10.

‘‘(ii) MEDICAL CARE COST ADJUSTMENT.—For purposes of clause (i), the medical care cost adjustment for any calendar year is the percentage (if any) by which—

‘‘(I) the medical care component of the Consumer Price Index (as defined in section 1(f)(5)) for August of the preceding calendar year, exceeds

‘‘(II) such component for August of 1996.

The Secretary shall, in consultation with the Secretary of Health and Human Services, prescribe an adjustment which the Secretary determines is more appropriate for purposes of this paragraph than the adjustment described in the preceding sentence, and the adjustment so prescribed shall apply in lieu of the adjustment described in the preceding sentence.

‘‘(11) CERTAIN PAYMENTS TO RELATIVES TREATED AS NOT PAID FOR MEDICAL CARE.—An amount paid for a qualified long-term care service (as defined in section 7702B(c)) provided to an individual shall be treated as not paid for medical care if such service is provided—

‘‘(A) by the spouse of the individual or by a relative (directly or through a partnership, corporation, or other entity) unless the service is provided by a licensed professional with respect to such service, or

‘‘(B) by a corporation or partnership which is related (within the meaning of section 267(b) or 707(b)) to the individual.

For purposes of this paragraph, the term ‘relative’ means an individual bearing a relationship to the individual which is described in any of paragraphs (1) through (8) of section 152(a). This paragraph shall not apply for purposes of section 105(b) with respect to reimbursements through insurance.’’.

(3) Paragraph (6) of section 213(d) is amended—

(A) by striking ‘‘subparagraphs (A) and (B)’’ and inserting ‘‘subparagraphs (A), (B), and (C)’’, and

(B) by striking ‘‘paragraph (1)(C)’’ in subparagraph (A) and inserting ‘‘paragraph (1)(D)’’.

(4) Paragraph (7) of section 213(d) is amended by striking ‘‘subparagraphs (A) and (B)’’ and inserting ‘‘subparagraphs (A), (B), and (C)’’.

(c) EFFECTIVE DATE.—The amendments made by this section shall apply to taxable years beginning after December 31, 1996.

SEC. 323. REPORTING REQUIREMENTS.

(a) GENERAL.—Subpart B of part III of subchapter A of chapter 61 is amended by adding at the end the following new section:

‘‘SEC. 6050Q. CERTAIN LONG-TERM CARE BENEFITS.

‘‘(a) REQUIREMENT OF REPORTING.—Any person who pays long-term care benefits shall make a return, according to the forms or regulations prescribed by the Secretary, setting forth—

‘‘(1) the aggregate amount of such benefits paid by such person to any individual during any calendar year,

‘‘(2) whether or not such benefits are paid in whole or in part on a per diem or other periodic basis without regard to the expenses incurred during the period to which the payments relate,

‘‘(3) the name, address, and TIN of such individual, and

‘‘(4) the name, address, and TIN of the chronically ill or terminally ill individual on account of whose condition such benefits are paid.

‘‘(b) STATEMENTS TO BE FURNISHED TO PERSONS WITH RESPECT TO WHOM INFORMATION IS REQUIRED.—Every person required to make a return under subsection (a) shall furnish to each individual whose name is required to be set forth in such return a written statement showing—

‘‘(1) the name of the person making the payments, and

‘‘(2) the aggregate amount of long-term care benefits paid to the individual which are required to be shown on such return.

The written statement required under the preceding sentence shall be furnished to the individual on or before January 31 of the year following the calendar year for which the return under subsection (a) was required to be made.

‘‘(c) LONG-TERM CARE BENEFITS.—For purposes of this section, the term ‘long-term care benefit’ means—

‘‘(1) any payment under a product which is advertised, marketed, or offered as long-term care insurance, and

‘‘(2) any payment which is excludable from gross income by reason of section 101(g).’’.

(b) PENALTIES.—

(1) Subparagraph (B) of section 6724(d)(1) is amended by redesignating clauses (ix) through (xiv) as clauses (x) through (xv), respectively, and by inserting after clause (viii) the following new clause:

‘‘(ix) section 6050Q (relating to certain long-term care benefits),’’.

(2) Paragraph (2) of section 6724(d) is amended by redesignating subparagraphs (Q) through (T) as subparagraphs (R) through (U), respectively, and by inserting after subparagraph (P) the following new subparagraph:

‘‘(Q) section 6050Q(b) (relating to certain long-term care benefits),’’.

(c) CLERICAL AMENDMENT.—The table of sections for subpart B of part III of subchapter A of chapter 61 is amended by adding at the end the following new item:

‘‘Sec. 6050Q. Certain long-term care benefits.’’.

(d) EFFECTIVE DATE.—The amendments made by this section shall apply to benefits paid after December 31, 1996.