As health plans and providers navigate the implications and components of the industry-reforming Consolidated Appropriations Act (CAA), federal agencies recently issued a final rule updating fees for the independent dispute resolution (IDR) process established within the CAA’s No Surprises Act. The...
News & Insights
April 24, 2023
Each July 31, heath plans pay an IRS fee to support the Patient-Centered Outcomes Research Institute (PCORI), a nonprofit research organization chartered by the Affordable Care Act to improve health care outcomes and experiences for patients. Self-funded plan sponsors pay the fee directly, while...
October 12, 2022
The Consolidated Appropriations Act (CAA) signed into law on December 27, 2020, and the Transparency in Coverage Act (TiC), adopted November 12, 2020, contain a number of initiatives designed to improve health care cost transparency and patient protections. Below is a calendar of key 2022 and 2023...
November 4, 2021
Within the IRS-issued Revenue Procedure 2021-36, the affordability threshold for the 2022 calendar year has been set to 9.61% of household income. This percentage is a decrease from the 2021 threshold of 9.83%. The affordability threshold is used to determine an individual’s eligibility for a...
November 3, 2020
The annual Patient-Centered Outcomes Research Institute (PCORI) fee for plans ending between October 1, 2020, and October 1, 2021, is $2.66. This is an increase from the 2020 rate of $2.54.
