WASHINGTON — The Council for Responsible Nutrition (CRN) has clarified its position on recent efforts to make dietary supplements eligible for reimbursement under Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs), stressing that not all trade groups are aligned on the scope of coverage.
Trade media reports have noted joint letters from the American Herbal Products Association (AHPA), CRN, the Consumer Healthcare Products Association (CHPA), and the United Natural Products Alliance (UNPA), alongside a separate letter from the Natural Products Association (NPA). While often covered as a unified effort, the groups are calling for different standards.
The joint letter requests the Internal Revenue Service (IRS) to revise Publication 502 so that all products legally marketed as dietary supplements with a Supplement Facts panel are considered reimbursable medical expenses. In contrast, NPA’s proposal would restrict eligibility to supplements that have either an FDA-approved health claim, a structure/function claim, or evidence of a mechanism of action.
CRN argued that its broader approach is simpler for retailers and plan administrators to apply and ensures equal treatment across the category. “If the product has a Supplement Facts panel, it’s covered,” the group stated, noting that more restrictive language could exclude widely used vitamins and minerals like vitamin C or magnesium that lack health claims.
The organization also warned that limiting eligibility would not reduce costs for the government, since companies could easily add claims to qualify, and that fringe supplements making unsubstantiated claims could still slip through under NPA’s narrower definition.
“CRN urges the IRS to take the category approach and recognize all dietary supplements as eligible for reimbursement,” the group concluded.
A Statement from the Council for Responsible Nutrition
Numerous trade publications have reported the efforts of the trade organizations to obtain coverage for dietary supplements in Flexible Spending Accounts and Healthcare Savings Accounts (FSAs and HSAs). The joint letters from AHPA, CRN, CHPA, and UNPA, as well as a separate one from NPA, have been covered collectively as if they are requesting the same end.
But there is a significant difference between the two.
The AHPA, CRN, CHPA, UNPA letter asks the IRS to revise its Publication 502 to read:
“You can include in medical expenses the cost of dietary supplements, provided that such products meet the definition of a dietary supplement as defined in section 201(ff) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(ff)) and are labeled with Supplement Facts labels that are compliant with federal regulations for these products.”
By contrast, the NPA letter asks:
“You can include in medical expenses the cost of “dietary supplements,” as defined in 21 U.S.C. 321(ff)(1), provided that such products are labeled with an FDA-authorized health claim, bear statements describing how they are intended to affect the structure or function of the human body, or include statements characterizing the documented mechanism by which the product maintains such structure or function.”
The joint letter asks the IRS to simply recognize all products lawfully marketed as a dietary supplement with a Supplement Facts box as medical expenses. The other letter would limit what can be reimbursed to only those products that contain a structure/function claim or an FDA-authorized health claim.
Here’s why CRN supports the broader language:
- It’s cleaner and easier for retailers and plan administrators to implement. If the product has a Supplement Facts panel, it’s covered. The store does not have to know what a health claim or a structure/function claim is to know that the product can be reimbursed.
- The broader language covers the entire category of dietary supplements, those products “intended to supplement the diet” whether through providing nutrition or supplementing with herbs or other ingredients. It doesn’t parse up the industry and create “winners and losers,” with some products covered and others left out.
- Some commonly used dietary supplements do not have a health claim or a structure/function claim on the label. For example, many “letter vitamin” and mineral products (ironically, the ones most familiar to consumers and with long histories of use) are marketed and labeled solely on the strength of the ingredient name. Why would we exclude items like vitamin C or magnesium (just because they don’t have a claim on the label) that consumers have relied on for decades?
- If the motivation is to limit the category of products covered by FSAs/HSAs, this is not the way to do it because it is easily circumvented. Products that don’t have a health claim or a structure/function claim now could easily add a claim to the label, making them eligible. So, there are no cost savings for the government by limiting the allowable supplements.
- If the motivation is to narrow the allowable products to more mainstream dietary supplements, that approach also has the opposite effect. Supplements that are considered "fringe products" because they make claims for sexual function, unrealistic weight loss, or explosive muscle growth all contain structure/function claims, albeit they may not be supportable or substantiated with credible science. However, they would still be covered under the more restrictive language because they contain a structure/function claim.
