PCORI fee rises 4.3%

By Allison Bell

October 12, 2015 at 11:27 AM

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The Internal Revenue Service (IRS) says the fee that funds the Patient-Centered Outcomes Research Institute (PCORI) will increase to $2.17 per covered life, from $2.08.

The 4.3 percent increase in the PCORI fee will apply to policy years and health plan years that end on or after Oct. 1, 2015, and before Oct. 1, 2016.

The IRS announced the increase in IRS Notice 2015-60.

Drafters of the Patient Protection and Affordable Care Act of 2010 (PPACA) created PCORI, and the PCORI fee, to try to increase the number of scientific studies that compare how well existing medical treatments work.

The PCORI fee provision, outlined in PPACA Section 4375, requires all health insurers and self-insured major medical plans to pay the fee. Affected issuers calculate their PCORI fee bills by multiplying the PCORI fee times the average number of lives covered during the policy year, or group plan year.

PCORI fee payments are due July 31.

For policy and plan years ending from Oct. 1, 2015, through Sept. 30, 2019, the secretary of the U.S. Department of Health and Human Services (HHS) is supposed to use data from the government's National Health Expenditures survey to adjust the PCORI fee for the annual health care cost inflation rate.

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