For policy plan years beginning after September 30, 2018 and ending before October 1, 2019 the PCORI fee will be $2.45. This will be the final plan year that the fees must be collected.
What is it?
The Patient-Centered Outcomes Research Trust Fund (PCORI) was established under the Affordable Care Act (ACA). The fees pay for research on ways to improve patient-centered outcomes. PCORI applies to both insured and self-insured health plans. (See the IRS for a chart of types of health plans covered).
How does a Plan Comply?
IRS Form 720 must be filed and the PCORI fee paid by July 31, 2019 for the final plan year. PCORI Fees are calculated by taking the average number of covered participants (includes spouse and dependents) for the health plans in force between September 30, 2018 and October 1, 2019. If you are not familiar with PCORI, you can get more information from the IRS PCORI Questions and Answers page.
Have you wondered where the money has gone? Well surprisingly, PCORI has followed its mandate to not only provide the data gathered to clinicians, but also provide it to patients in a manner that can be easily understood.
This Evidence Update on “Choosing an Antibiotic for Your Child’s Ear, Nose, or Throat Infection” is an example of how patients (your employees) can benefit from the fees that have been paid into the trust fund. If you’re interested in seeing how the money has been spent, you can go to PCORI.org and check out the other areas they have investigated.
Employers may want to take advantage of some of the research to help review ways to improve healthcare outcomes for their insurance and wellness benefit programs. It can also help when trying to handle health issues that can affect an employee’s job. For example, the research on opioid addiction is not only timely as it is being discussed on a national level but also because it is a concern for many employers.
For once it’s nice to be able to read something from the government that doesn’t require a law degree or better glasses!
Finally, now that healthcare is once again a topic of discussion in Washington, I wouldn’t be surprised to see this or a similar type of fee program extended. Stay tuned for updates!
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