Cafeteria plans with health flexible spending accounts must be amended to comply with PPACA's definition of "qualified medical expenses" by June 30, 2011 for calendar year plans. Ordinarily, cafeteria plan amendments must be adopted prior to the effective date of the change, or December 31 for calendar year plans. However, the Internal Revenue Service (IRS) provided a six-month extension for this amendment deadline.

A "qualified medical expense" is considered an expense incurred on or after January 1, 2011 for a medicine or drug that is insulin, or that requires a prescription or is available without a prescription but the individual has a prescription.