On November 14, 2022, the IRS released Notice 2022-59, which increases the Patient-Centered Outcomes Research Institute (PCORI) fee amount for plan years ending on or after October 1, 2022, and before October 1, 2023. The updated PCORI fee amount is $3.00 multiplied by the average number of lives covered under the plan.
What Is the PCORI Fee?
The PCORI fee is a fee on issuers of specified health insurance policies and plan sponsors of applicable self-insured health plans that helps to fund the Patient-Centered Outcomes Research Institute (PCORI). The institute helps patients, clinicians, purchasers, and policymakers make better-informed healthcare choices by advancing clinical effectiveness research.
PCORI fees under the Affordable Care Act were scheduled to end after September 30, 2019; however, Congress extended these fees to be assessed by the IRS under the Further Consolidated Appropriations Act of 2020 for another ten years, until at least September 30, 2029.
Fully insured plans are to be assessed the applicable PCORI fee amount through their monthly premium payments made to their health insurance carrier. Self-insured plans pay this fee as part of the annual IRS Form 720 filing which is generally due by July 31 of each year.
Next Steps for Employers
Employers with fully insured plans may confirm with their carrier that these fees are being paid through the plan, and employers of certain self-insured health plans should ensure they are paying PCORI fees annually.
