The Internal Revenue Service has issued its final rule (pdf) on fees on certain health insurers to fund the Patient-Centered Outcomes Research Trust Fund.
The Patient Protection and Affordable Care Act established the Patient-Centered Outcomes Research Institute, a non-profit organization designed to conduct and collate research to help patients, clinicians, purchasers and policy-makers make informed health decisions. The PPACA also established the Patient-Centered Outcomes Research Trust Fund to finance PCORI; this fund will in turn be financed in part by fees to certain payors.
The fee affects issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans. A specified health insurance policy is any accident or health insurance policy, including a policy under a group health plan, issued for U.S. residents. A plan sponsor is the employer or the employee organization of a plan established or maintained by a single employer or employee organization.
The fee applies to specified policies and plans ending on or after Oct. 1, 2012 and before Oct. 1, 2019. The fee is two dollars (one dollar for policy or plan years ending before Oct. 1, 2013) multiplied by the average number of lives covered under the policy or plan. For policy or plan years ending Oct. 1, 2014, the fee is increased based on increases in the projected per capita amount of National Health Expenditures.
This rule is effective Dec. 6.
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The Patient Protection and Affordable Care Act established the Patient-Centered Outcomes Research Institute, a non-profit organization designed to conduct and collate research to help patients, clinicians, purchasers and policy-makers make informed health decisions. The PPACA also established the Patient-Centered Outcomes Research Trust Fund to finance PCORI; this fund will in turn be financed in part by fees to certain payors.
The fee affects issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans. A specified health insurance policy is any accident or health insurance policy, including a policy under a group health plan, issued for U.S. residents. A plan sponsor is the employer or the employee organization of a plan established or maintained by a single employer or employee organization.
The fee applies to specified policies and plans ending on or after Oct. 1, 2012 and before Oct. 1, 2019. The fee is two dollars (one dollar for policy or plan years ending before Oct. 1, 2013) multiplied by the average number of lives covered under the policy or plan. For policy or plan years ending Oct. 1, 2014, the fee is increased based on increases in the projected per capita amount of National Health Expenditures.
This rule is effective Dec. 6.
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